Dr. Azibanigha Scott: STOP Female Genital Mutilation

February 6th was the United Nations International Day of zero tolerance for Female Genital Mutilation. According to the World Health Organization (WHO), Female Genital Mutilation (FGM) comprises all procedures that involve partial or total removal of the external female genitalia or other injuries to the female genital organs for non-medical reasons. Female genital mutilation is recognized internationally as a violation of the human rights of girls and women.

The various procedures done are classified into 4 types:

• Type 1 – referred to as clitoridectomy – is the partial or total removal of the clitoris or the prepuce (a fold of skin around the clitoris).
• Type 2 – referred to as Excision, is either partial or total removal of the clitoris and the labia minora (the inner folds of the vulva) with or without excision of the labia majora (the outer folds of skin of the vulva).
• Type 3 – also known as Infibulation, is the narrowing of the vaginal opening through the creation of a covering seal (the labia majora is cut and repositioned) with or without removal of the clitoris.
• Type 4 – includes all harmful procedures done to the female genitalia for non-medical purposes such as pricking, piercing, incising, scraping and cauterizing the genital area.

The practice of female genital mutilation is more common than you think.  According to WHO, it is estimated that more than three million girls are at risk of female genital mutilation annually. More than 200 million girls and women alive today have been mutilated in 30 countries in Africa, the Middle East and Asia where the bulk of female genital mutilation is done. The practice is common in Western, Eastern and Northeastern regions of Africa, in some countries in the Middle East and Asia, as well as among migrants from these areas. This makes it a global issue. It is safe to say that some traditional beliefs guide female genital mutilations because immigrants from nations where female genital mutilation is practiced still take their female children to their home countries for circumcision.

An article by T.C Okeke et al – published in the Annals of Medical and Health Sciences Research – reviewed female genital mutilation in Nigeria. Given its large population, Nigeria has the highest absolute number of cases of female genital mutilation in the world, thereby accounting for about one-quarter of the estimated 115 – 130 million circumcised women worldwide. Female genital mutilation in Nigeria has the highest prevalence in the South-south ( 77%) followed by the Southeast (68%), Southwest (65%) and at a smaller scale in the North.

The national prevalence of female genital mutilation in Nigeria is currently 41% amongst adult women. Even though that value is progressively declining, female genital mutilation is still happening.

There are many reasons why people still practice female genital mutilation. These include traditional practices that have to be preserved, superstitious beliefs practiced for the preservation of chastity and purification, enhancing fertility and increasing matrimonial opportunities and to prevent mother and child from dying during childbirth. Some are what I call ‘tribo-legal’ reasons – tribes where women cannot inherit property or be regarded as indigenes if not circumcised.

There are no health benefits of female genital mutilation but rather, it is fraught with several complications that can be immediate or long term.

Immediate complications include:

• Severe pain.
• Genital tissue swelling.
• Infection, such as tetanus – because the procedure is done in poor hygienic conditions.
• Urinary problems.
• Wound healing problems.
• Injury to surrounding genital tissue.
• Severe bleeding and overwhelming infection leading to shock.
• Death – people die from this.

Long-term complications include:

• Urinary problems.
• Vagina problems like foul-smelling discharge, itching, other infections.
• Painful menstruation.
• Sexual problems, such as painful sexual intercourse and decreased sexual satisfaction. Because the clitoris is the female sexual organ and the majority of orgasms come from the clitoris so some of them cannot experience an orgasm.
• The need to have corrective surgeries later in life owing to complications.
• Psychological problems like depression, anxiety, post-traumatic stress disorder, low self-esteem.

Stopping female genital mutilation is a collective effort at all levels of our society. There are ongoing works by the United Nations and WHO to combat FGM. There are also other things to be done at our own level – like educating our loved ones and pledging as a community to end FGM.

Do you have any experience or know anyone that might have had FGM? I’d love to know.

If you suffer from the psychological trauma of FGM, you need to find help as soon as you can.