Female Genital Mutilation (FGM): A Medical Perspective on a Harmful Practice

Female Genital Mutilation (FGM) is a deeply entrenched cultural practice involving the partial or total removal of the external female genitalia or other forms of injury to the female genital organs.

This article aims to provide an in-depth understanding of the medical aspects of FGM, including its types, prevalence, medical consequences, and the individuals at risk.

Types of FGM

FGM encompasses four main types:

1. Type I – Clitoridectomy: Partial or total removal of the clitoris and/or the prepuce.
2. Type II – Excision: Partial or total removal of the clitoris and the inner labia, with or without excision of the outer labia.
3. Type III – Infibulation: Narrowing of the vaginal opening by cutting and repositioning the inner or outer labia, often combined with clitoral removal.
4. Type IV – Other: Includes various harmful procedures like pricking, piercing, incising, scraping, and cauterizing the genital area.

Prevalence and Impact

FGM is predominantly practiced in 30 countries across Africa, the Middle East, and Asia. Shockingly, over 200 million girls and women worldwide have undergone FGM. It is usually performed on young girls between infancy and age 15, violating their human rights and perpetuating gender inequality.

Medical Consequences of FGM

The medical consequences of FGM can have both immediate and long-term effects. These consequences include:

Immediate Complications:

1. Severe pain
2. Excessive bleeding (haemorrhage)
3. Genital tissue swelling
4. Fever
5. Infections (e.g., tetanus)
6. Urinary problems
7. Wound healing problems
8. Injury to surrounding genital tissue
9. Shock
10. Death

Long-term Complications:

1. Urinary problems: Painful urination, urinary tract infections
2. Vaginal problems: Discharge, itching, bacterial vaginosis, and other infections
3. Menstrual problems: Painful menstruation, difficulty in passing menstrual blood, etc.
4. Scar tissue and keloid formation
5. Sexual problems: Pain during intercourse, decreased satisfaction
6. Increased risk of childbirth complications: Difficult delivery, excessive bleeding, caesarean section, the need to resuscitate the baby, etc.
7. Need for later surgeries: The sealing or narrowing of the vaginal opening (type III) may require deinfibulation to allow for sexual intercourse and childbirth, increasing risks.
8. Psychological problems: Depression, anxiety, post-traumatic stress disorder, low self-esteem.

Factors Influencing FGM

Cultural and social factors play a crucial role in perpetuating FGM. These factors include:

1. Social convention: The pressure to conform to societal norms and the fear of rejection from the community.
2. Preparation for adulthood and marriage: FGM is often considered necessary for raising a girl and controlling her sexuality, promoting premarital virginity and marital fidelity.
3. Religious beliefs: Although no religious texts prescribe FGM, some communities associate it with religious support. However, religious leaders have varying positions on FGM, with some advocating for its abandonment.
4. Medicalization: In certain cases, healthcare providers mistakenly believe that medicalizing FGM reduces complications or view it as a step towards abandonment. Financial incentives may also influence the involvement of healthcare providers.

Abandonment and Prevention Efforts

To combat FGM, comprehensive efforts are necessary. These include:

1. Education and awareness: Providing information about the health risks, human rights violations, and long-term consequences of FGM.
2. Legislation and policy: Implementing laws and policies that criminalize FGM and protect individuals from the practice.
3. Community engagement: Involving community leaders, traditional practitioners, and influential members to foster dialogue, challenge social norms, and promote abandonment.
4. Empowering healthcare providers: Supporting healthcare professionals in advocating against FGM, offering alternative rituals, and providing medical care to survivors.
5. International cooperation: Promoting collaboration between governments, organizations, and communities to address FGM on a global scale.

Female Genital Mutilation is a deeply rooted cultural practice that inflicts significant physical and psychological harm upon girls and women. It violates human rights, perpetuates gender inequality, and poses substantial health risks.

Through education, legislation, community engagement, and empowering healthcare providers, we can work towards its abandonment. By fostering awareness and taking collective action, we can protect the rights, well-being, and future of countless girls and women worldwide.