Types of FGM
Female Genital Mutilation comprises all procedures involving the removal of the external female genitalia or other injury to the female genital organs for non-medical reasons. Most often, FGM is practiced on girls and young women under 18. FGM is not prescribed by any religion and has no health benefits. On the contrary the practice can cause life-lasting physical and psychological trauma.
200 million girls and women alive today have undergone FGM. At current rates, an additional estimated 68 million girls face being cut by 2030.
Female genital mutilation is classified into four types:
- Type 1: Also known as clitoridectomy, this type consists of partial or total removal of the external part of the clitoris and/or its prepuce (clitoral hood).
- Type 2: Also known as excision, the external part of clitoris and labia minora are partially or totally removed, with or without excision of the labia majora.
- Type 3: It is also known as infibulation or pharaonic type. The procedure consists of narrowing the vaginal orifice with creation of a covering seal by cutting and appositioning the labia minora and/or labia majora, with or without removal of the external part of clitoris. The appositioning of the wound edges consists of stitching or holding the cut areas together for a certain period of time (for example, girls’ legs are bound together), to create the covering seal. A small opening is left for urine and menstrual blood to escape.
- Type 4: This type consists of all other procedures to the genitalia of women for non-medical purposes, such as pricking, piercing, incising, scraping and cauterization.
Recent estimates indicate that around 90% of cases include clitoridectomy, excision or cases where girls’ genitals are “nicked” but no flesh removed (Type IV), and about 10% are infibulations (WHO).
How is FGM practised?
The type of mutilation practised, the age at which it is carried out and the way in which it is done, vary according to a variety of factors. These include:
- The women or girls’ ethnic group;
- What country they are living in (whether in a rural or urban area);
- Their socio-economic background.
The procedure is carried out at a variety of ages, ranging from shortly after birth to sometime during the first pregnancy. Although not always the case, it most commonly occurs between the ages of 0 to 15 years and the age is decreasing in some countries. The practice has been linked in some countries with rites of passage for women.
FGM is usually performed by traditional practitioners using a sharp object such as a knife, a razor blade or broken glass. There is also evidence of an increase in the performance of FGM by medical personnel. However, medicalisation of FGM is denounced by the World Health Organisation.
Consequences of FGM
Immediate consequences of FGM include severe pain and bleeding, shock, difficulty in passing urine, infections, injury to nearby genital tissue and sometimes death. The procedure can result in death through severe bleeding leading to haemorrhagic shock, neurogenic shock as a result of pain and trauma, and overwhelming infection and septicaemia, according to Manfred Nowak, UN Special Rapporteur on Torture and other Cruel, Inhuman or Degrading Treatment or Punishment.
Almost all women who have undergone FGM experience pain and bleeding as a consequence of the procedure. The event itself is traumatic as girls are held down during the procedure. Risk and complications increase with the type of FGM and are more severe and prevalent with infibulations.
“The pain inflicted by FGM does not stop with the initial procedure, but often continues as ongoing torture throughout a woman’s life”, says Manfred Nowak, UN Special Rapporteur on Torture.
In addition to the severe pain during and in the weeks following the cutting, women who have undergone FGM experience various long-term effects – physical, sexual and psychological.
Women may experience chronic pain, chronic pelvic infections, development of cysts, abscesses and genital ulcers, excessive scar tissue formation, infection of the reproductive system, decreased sexual enjoyment and psychological consequences, such as post-traumatic stress disorder.
Additional risks for complications from infibulations include urinary and menstrual problems, infertility, later surgery (defibulation and reinfibulation) and painful sexual intercourse. Sexual intercourse can only take place after opening the infibulation, through surgery or penetrative sexual intercourse. Consequently, sexual intercourse is frequently painful during the first weeks after sexual initiation and the male partner can also experience pain and complications.
When giving birth, the scar tissue might tear, or the opening needs to be cut to allow the baby to come out. After childbirth, women from some ethnic communities are often sown up again to make them “tight” for their husband (reinfibulation). Such cutting and restitching of a woman’s genitalia results in painful scar tissue.
A multi-country study by WHO in six African countries, showed that women who had undergone FGM, had significantly increased risks for adverse events during childbirth, and that genital mutilation in mothers has negative effects on their newborn babies. According to the study, an additional one to two babies per 100 deliveries die as a result of FGM. Read the WHO collaborative study on FGM and obstetric outcome
FGM violates children’s rights
FGM is practised on girls usually in the range of 0-15 years. Hence, the practice of FGM violates children’s rights as defined in the Convention on the Rights of the Child (CRC):
- The right to be free from discrimination (Article 2);
- The right to be protected from all forms of mental and physical violence and maltreatment (Article 19(1));
- The right to highest attainable standard of health (Article 24);
- The right of freedom from torture or other cruel, inhuman or degrading treatment or punishment (Article 37).
According to the UN Committee on CRC, “discrimination against girl children is a serious violation of rights, affecting their survival and all areas of their young lives as well as restricting their capacity to contribute positively to society” (2005).
Moreover, the negative effects of FGM on children’s development contravene the best interest of the child – a central notion to the Convention (Article 3).
Because it is performed without the consent of the girls, it also breaches the right to express freely one’s view (Article 12). Even if the girl child is aware of the practice, the issue of consent remains, as girls are usually too young to be consulted and have no voice in the decision made on their behalf by members of their family. On the other hand, adolescent girls and women very often agree to undergo FGM because they fear the non-acceptance of their communities, families and peers, according to 2008 Report of the Special Rapporteur on Torture.
FGM also impacts on the right to dignity and directly conflicts with the right to physical integrity, as it involves the mutilation of healthy body parts.
The Committee on the Convention on the Rights of the Child has said that States party to the Convention have an obligation “to protect adolescents from all harmful traditional practices, such as early marriages, honour killings and female genital mutilation” (2003).
Frequently Asked Questions
How many women and girls are affected?
An estimated 200 million girls and women alive today are believed to have been subjected to FGM; but rates of FGM are increasing, a reflection of global population growth. Girls and women who have undergone FGM live predominately in sub-Saharan Africa and the Arab States, but FGM is also practiced in select countries in Asia, Eastern Europe and Latin America. It is also practiced among migrant populations throughout Europe, North America, Australia and New Zealand. If FGM practices continue at recent levels, 68 million girls will be cut between 2015 and 2030 in 25 countries where FGM is routinely practiced and more recent data are available.
A key challenge is not only protecting girls who are currently at risk but also ensuring that those to be born in the future will be free from the dangers of the practice. This is especially important considering that FGM-concentrated countries are generally experiencing high population growth and have large youth populations. In 2019, it was estimated that 4.1 million girls were at risk of FGM. This number of girls cut each year is projected to rise to 4.6 million girls in the year 2030. In 2020 and 2022, COVID-19 compounded the vulnerability of girls and women, especially those at risk of FGM. The pandemic has further entrenched gender inequalities, economic disparities and health risks faced by women and girls, and disrupted prevention programmes for the elimination of FGM and other harmful practices. UNFPA estimates that due to COVID-19, two million cases of FGM could occur over the next decade that would otherwise have been averted, resulting in a 33 per cent reduction in progress towards ending FGM practice.
How does FGM affect the health of women and girls?
FGM has serious implications for the sexual and reproductive health of girls and women. The effects of FGM 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 girl/woman undergoing the procedure. Complications may occur in all types of FGM, but are most frequent with infibulation.
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 septicemia. 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.
Infibulation, or type III FGM, may cause complete vaginal obstruction resulting in the accumulation of menstrual flow in the vagina and uterus. Infibulation 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. Infibulation is also linked to menstrual and urination disorders, recurrent bladder and urinary tract infections, fistulae and infertility.
What are the consequences for childbirth?
A recent study found that, compared with women who had not been subjected to FGM, those who had undergone FGM faced a significantly greater risk of requiring a Caesarean section, an episiotomy and an extended hospital stay, and also of suffering post-partum haemorrhage.
Women who have undergone infibulation are more likely to suffer from prolonged and obstructed labour, sometimes resulting in foetal death and obstetric fistula. The infants of mothers who have undergone more extensive forms of FGM are at an increased risk of dying at birth.
Very recent estimates by WHO, UNICEF, UNFPA, The World Bank and the United Nations Population Division reveal that most of the high-FGM-prevalence countries also have high maternal mortality ratios and high numbers of maternal death. Two high-FGM-prevalence countries are among the four countries with the highest numbers of maternal death globally. Five of the high-prevalence countries have maternal mortality ratios of 550 per 100,000 live births and above.
Is there a link between FGM and the risk of HIV infection?
When one tool is used to cut several girls, as is often the case in communities where large groups of girls are cut on the same day during a socio-cultural rite, there is a risk of HIV transmission.
Additionally, due to damage to the female sexual organs, sexual intercourse can result in the laceration of tissue, which greatly increases risk of HIV transmission. The same is true for the blood loss that accompanies childbirth.
What are the psychological effects of FGM?
FGM may have lasting effects on women and girls who undergo FGM. The psychological stress of the procedure may trigger behavioural disturbances in children, closely linked to loss of trust and confidence in caregivers. In the longer term, women may suffer feelings of anxiety and depression. Sexual dysfunction may also contribute to marital conflicts or divorce.
What are the different types of FGM?
The World Health Organization (WHO) has identified four types of FGM:
Type I, also called clitoridectomy: Partial or total removal of the clitoris and/or the prepuce.
Type II, also called excision: Partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora. The amount of tissue that is removed varies widely from community to community.
Type III, also called infibulation: Narrowing of the vaginal orifice with a covering seal. 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.
Type IV: All other harmful procedures to the female genitalia for non-medical purposes, for example: pricking, piercing, incising, scraping or cauterization.
Other terms related to FGM include incision, deinfibulation and reinfibulation:
Incision refers to making cuts in the clitoris or cutting free the clitoral prepuce, but it also relates to incisions made in the vaginal wall and to incision of the perineum and the symphysis.
Deinfibulation refers to the practice of cutting open a woman who has been infibulated to allow intercourse or to facilitate childbirth.
Reinfibulation is the practice of sewing the external labia back together after deinfibulation.
Which types are most common?
Types I and II are the most common, but there is variation among countries. Type III – infibulation – is experienced by about 10 per cent of all affected women and is most likely to occur in Somalia, northern Sudan and Djibouti.
Why are there different terms to describe FGM, such as female genital cutting and female circumcision?
The terminology used for this procedure has gone through various changes. When the practice first came to international attention, it was generally referred to as “female circumcision.” (In Eastern and Northern Africa, this term is often used to describe FGM type I.) However, the term “female circumcision” has been criticized for drawing a parallel with male circumcision and creating confusion between the two distinct practices. Adding to the confusion is the fact that health experts in many Eastern and Southern African countries encourage male circumcision to reduce HIV transmission; FGM, on the other hand, can increase the risk of HIV transmission.
It is also sometimes argued that the term obscures the serious physical and psychological effects of genital cutting on women. UNFPA does not encourage use of the term “female circumcision” because the health implications of male and female circumcision are very different.
The term “female genital mutilation” is used by a wide range of women’s health and human rights organizations. It establishes a clear distinction from male circumcision. Use of the word “mutilation” also emphasizes the gravity of the act and reinforces that the practice is a violation of women’s and girls’ basic human rights. This expression gained support in the late 1970s, and since 1994, it has been used in several United Nations conference documents and has served as a policy and advocacy tool. In Resolution 65/170, Member States clearly stated that female genital mutilation should be used to refer to this harmful practice.
In the late 1990s the term “female genital cutting” was introduced, partly in response to dissatisfaction with the term “female genital mutilation.” There is concern that communities could find the term “mutilation” demeaning, or that it could imply that parents or practitioners perform this procedure maliciously. Some fear the term “female genital mutilation” could alienate practicing communities, or even cause a backlash, possibly increasing the number of girls subjected to the practice.
Some organizations embrace both terms, referring to “female genital mutilation/cutting” or FGM/C.
What terminology does UNFPA use?
UNFPA embraces a human rights perspective on the issue, and the term “female genital mutilation” more accurately describes the practice from a human rights viewpoint.
Today, a greater number of countries have outlawed the practice, and an increasing number of communities have committed to abandon it, indicating that the social and cultural perceptions of the practice are being challenged by communities themselves, along with national, regional and international decision-makers. Therefore, it is time to accelerate the momentum towards full abandonment of the practice by emphasizing the human-rights aspect of the issue.
Additionally, the term “female genital mutilation (FGM)” is used in a number of UN and intergovernmental documents. One recent document is the 2016 UN Secretary General’s Report (A/71/209) on Intensifying global efforts for the elimination of female genital mutilations. Other documents using the term “female genital mutilation” include: Report of the Secretary-General on Ending Female Genital Mutilation, Communication from the Commission to the European Parliament and the Council: Towards the elimination of female genital mutilation, Protocol to the African Charter on Human and Peoples’ Rights on the Rights of Women in Africa; Beijing Declaration and Platform for Action; and Eliminating female genital mutilation: An interagency statement. And each year on 6 February, the United Nations observes the “International Day of Zero Tolerance for Female Genital Mutilation.”
Where does the practice come from?
The origins of the practice are unclear. It predates the rise of Christianity and Islam. It is said some Egyptian mummies display characteristics of FGM. Historians such as Herodotus claim that, in the fifth century BC, the Phoenicians, the Hittites and the Ethiopians practiced circumcision. It is also reported that circumcision rites were practiced in tropical zones of Africa, in the Philippines, by certain tribes in the Upper Amazon, by women of the Arunta tribe in Australia, and by certain early Romans and Arabs. As recent as the 1950s, clitoridectomy was practiced in Western Europe and the United States to treat perceived ailments including hysteria, epilepsy, mental disorders, masturbation, nymphomania and melancholia. In other words, the practice of FGM has been followed by many different peoples and societies across the ages and continents.
At what age is FGM performed?
It varies. In some areas, FGM is carried out during infancy – as early as a couple of days after birth. 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 and 15 years.
Where is FGM practiced?
FGM is currently documented in 92 countries around the world through nationally representative data, indirect estimates (usually in countries where FGM is mainly practiced by diaspora communities), small-scale studies, or anecdotal evidence and media reports. This highlights the global nature of this harmful practice and the need for a global and comprehensive response in order to eliminate it.
In Africa, FGM is known to be practiced among certain communities in 33 countries: Benin, Burkina Faso, Cameroon, Central African Republic, Chad, Cote d’Ivoire, Democratic Republic of Congo, Djibouti, Egypt, Eritrea, Ethiopia, Gambia, Ghana, Guinea, Guinea-Bissau, Kenya, Liberia, Malawi, Mali, Mauritania, Niger, Nigeria, Senegal, Sierra Leone, Somalia, South Africa, South Sudan, Sudan, Tanzania, Togo, Uganda, Zambia and Zimbabwe
Certain ethnic groups in Asian countries practice FGM, including in communities in India, Indonesia, Malaysia, the Maldives, Pakistan and Sri Lanka.
In the Middle East, the practice occurs in Oman, the United Arab Emirates and Yemen, as well as in Iraq, Iran, Jordan and the State of Palestine.
In Eastern Europe, recent info shows that certain communities are practicing FGM in Georgia and the Russian Federation.
In South America, certain communities are known to practice FGM in Colombia, Ecuador, Panama and Peru.
And in many western countries, including Australia, Canada, New Zealand, the United States, the United Kingdom and various European countries, FGM is practiced among diaspora populations from areas where the practice is common.
Who performs FGM?
FGM is usually carried out by elderly people in the community (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, 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. According to recent UNFPA’s estimates, around one in four girls and women between the ages of 15 and 49 who have undergone FGM (or 52 million) were cut by health personnel. (In some countries, this can reach as high as three in four girls.) This proportion is twice as high among adolescents (34 per cent among those between the ages of 15 and 19) compared to older women (16 per cent among those between the ages of 45 and 49). According to estimates from demographic and health surveys and multiple indicator cluster surveys, countries where the majority of FGM cases are performed by health workers are Egypt (38%), Sudan (67%), Kenya (15%), Nigeria (13%) and Guinea (15%).
What instruments are used to perform FGM?
FGM is carried out with special knives, scissors, scalpels, pieces of glass or razor blades. Anaesthetic and 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 is FGM performed?
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 and women, usually without question, and anyone that does not 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.
The reasons given for practicing FGM fall generally into five categories:
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.
Sociological and 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.
Hygiene and aesthetic reasons: In some communities, the external female genitalia are considered dirty and ugly and are removed, ostensibly to promote hygiene and aesthetic appeal.
Religious reasons: Although FGM is not endorsed by either Islam or by Christianity, supposed religious doctrine is often used to justify the practice.
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.
Is FGM required by certain religions?
No religion promotes or condones FGM. Still, more than half of girls and women in four out of 14 countries where data is available saw FGM as a religious requirement. And although FGM is often perceived as being connected to Islam, perhaps because it is practiced among many Muslim groups, not all Islamic groups practice FGM, and many non-Islamic groups do, including some Christians, Ethiopian Jews, and followers of certain traditional African religions. FGM is thus a cultural rather than a religious practice. In fact, many religious leaders have denounced it.
Since FGM is part of a cultural tradition, can it still be condemned?
Yes. Culture and tradition provide a framework for human well-being, and cultural arguments cannot be used to condone violence against people, male or female. Moreover, culture is not static, but constantly changing and adapting. Nevertheless, activities for the elimination of FGM should be developed and implemented in a way that is sensitive to the cultural and social background of the communities that practice it. Behaviour can change when people understand the hazards of certain practices and when they realize that it is possible to give up harmful practices without giving up meaningful aspects of their culture.
Does anyone have the right to interfere in age-old cultural traditions such as FGM?
Every child has the right to be protected from harm, in all settings and at all times. The movement to end FGM – often local in origin – is intended to protect girls from profound, permanent and completely unnecessary harm. The evidence shows that most people in affected countries want to stop cutting girls, and that overall support for FGM is declining even in countries where the practice is almost universal (such as Egypt and Sudan). Ending FGM will take intensive and sustained collaboration from all parts of society, including families and communities, religious and other leaders, the media, governments and the international community.
What is the link between FGM and ethnicity?
Ethnicity is the most significant factor in FGM prevalence, cutting across socio-economic class and level of education. Members of certain ethnic groups often adhere to the same social norms, including whether or not to practice FGM, regardless of where they live. The FGM prevalence among ethnic Somalis living in Kenya, for example, at 94 per cent, is closer to the 99 per cent prevalence in Somalia than the Kenyan national average of 21 per cent, according to the most recent information available.
But there are exceptions. In Senegal, for example, there are major variations in FGM prevalence among Mandingue women depending on where they live – 56 per cent in urban areas versus 79 per cent in rural areas. Similarly, FGM prevalence among the Poular ranges from 39 per cent in urban areas to 67 per cent in rural areas.
What do women and girls who have experienced FGM say about it themselves?
Women around the world are speaking out about their experiences and advocating change.
“It is what my grandmother called the three feminine sorrows: the day of circumcision, the wedding night and the birth of a baby.” –From “The Three Feminine Sorrows,” a Somali poem
“My two sisters, myself and our mother went to visit our family back home. I assumed we were going for a holiday. A bit later they told us that we were going to be infibulated. The day before our operation was due to take place, another girl was infibulated and she died because of the operation. We were so scared and didn’t want to suffer the same fate. But our parents told us it was an obligation, so we went. We fought back; we really thought we were going to die because of the pain. You have one woman holding your mouth so you won’t scream, two holding your chest and the other two holding your legs. After we were infibulated, we had rope tied across our legs so it was like we had to learn to walk again. We had to try to go to the toilet. If you couldn’t pass water in the next 10 days something was wrong. We were lucky, I suppose. We gradually recovered and didn’t die like the other girl. But the memory and the pain never really go away.” –Zainab, who was infibulated at the age of 8 (from WHO)
“I will never subject my child to FGM if she happens to be a girl, and I will teach her the consequences of the practice early on.” –Kadiga, Ethiopia
“In my village there is one girl who is younger than I am who has not been cut because I discussed the issue with her parents. I told them how much the operation had hurt me, how it had traumatized me and made me not trust my own parents. They decided they did not want this to happen to their daughter.” –Meaza, 15 years old
What does the term “medicalization of FGM” mean?
According to WHO, the medicalization of FGM is when FGM is performed by a health-care provider, such as a community health worker, midwife, nurse or doctor. Medicalized FGM can take place in a public or private clinic, at home or elsewhere. It also includes the procedure of reinfibulation at any point in time in a woman’s life. In 2010, a joint interagency Global Strategy to Stop Health-Care Providers from Performing FGM was released. In 2016, WHO also released guidelines on the management of health complications from FGM. This strategy reflects consensus between international experts, United Nations entities and the Member States they represent. In addition, the global commitment to eliminate all forms of FGM by 2030 is clearly stated in target 5.3 of the Sustainable Development Goals (SDG).
Isn’t it safer for FGM to be performed by a skilled health worker rather than by somebody without a medical background?
FGM can never be “safe”. Even when the procedure is performed in a sterile environment and by a health-care professional, there can be serious health consequences immediately and later in life. Medicalized FGM gives a false sense of security. There are serious risks associated with all forms of FGM, including medicalized FGM.
In addition, there is no medical justification for FGM. Advocating any form of cutting or harm to the genitals of girls and women, and suggesting that medical personnel should perform it is unacceptable from a public health and human rights perspective. Trained health professionals who perform female genital mutilation are violating girls’ and women’s rights to life, physical integrity and health. They are also violating the fundamental medical ethic to “do no harm.”
Furthermore, the belief that a “minor” genital cut will help avoid more severe forms of FGM is unproven. Several studies have shown that girls can be subjected to FGM repeatedly when members of their family or community are dissatisfied with the results of earlier procedures. There is also evidence that FGM procedures described as “just a nick” are often actually more severe forms of FGM. One study from Sudan found that, among the women who claimed to have undergone a type of FGM considered “just a prick,” about one third had actually been subjected to infibulation, and all had experienced the removal of their clitoris and labia minora.
When medical personnel perform FGM, they wrongly legitimize the practice as medically sound or beneficial for girls and women’s health. And because medical personnel often hold power, authority and respect in society, it can also further institutionalize the procedure.
In which countries is FGM banned by law?
According to the 2021 edition of the World Bank’s “Compendium of International and National Legal Frameworks on Female Genital Mutilation”, 84 countries in the world have domestic legislation that either specifically prohibits FGM or allows FGM to be prosecuted through other laws, such as the criminal or penal code, child protections laws, violence against women laws or domestic violence laws.
Africa: Algeria (2015); Benin (2003); Burkina Faso (1996); Cameroon (2016); Central African Republic (1996, 2006); Chad (2002); Comoros (1982); Congo Republic (2002); Côte d’Ivoire (1998); Djibouti (1994, 2009); Democratic Republic of the Congo (2006); Egypt (2008); Eritrea (2007, 2015); Ethiopia (2004); The Gambia (2015); Ghana (1994, 2007); Guinea (1965, 2000, 2016); Guinea Bissau (2011); Liberia (2018, by one-year executive order); Kenya (2001, 2011); Malawi (2000); Mauritania (2005); Mozambique (2014); Niger (2003); Nigeria (2015); Senegal (1999); Sierra Leone (2007); Somalia (2001)*; South Africa (2005); Sudan (2020); South Sudan (2008); Tanzania (1998); Togo (1998); Uganda (2010); Zambia (2005, 2011); Zimbabwe (2006).
Others: Australia (6 out of 8 states between 1994-2006); Austria (1974, 2002); Bahrain (1976); Belgium (2000); Brazil (1984); Bulgaria (1968); Canada (1997); Colombia (2006, Resolution No. 001 of 2009 by indigenous authorities); Croatia (2013); Cyprus (2003); Czech Republic (2009); Denmark (2003); Estonia (2001); Finland (2013); France (1979); Hungary (2012); India (1860); Italy (2006); Iran (1991); Iraq (2011, only applicable in Kurdistan); Ireland (2012); Kuwait (2015); Georgia (Germany (2013); Greece (1951); Latvia (2005); Lithuania (2000); Luxembourg (on mutilations only, not specifically on ‘genital’ mutilation, 2008); Malta (1854); Mexico (2020); Netherlands (1881); New Zealand (1995); Norway (1995); Oman (2019), Pakistan (1860); Panama (2007); Peru (1991); Philippines (1930); Poland (2003); Portugal (2007); Romania (2017); Slovakia (2005); Slovenia (2008); Spain (2003); Sweden (1982,1998); Switzerland (2005, 2012); Trinidad and Tobago (2012); United Kingdom (1985; 2003); United States (1996).
Penalties range from a minimum of six months to a maximum of life in prison. Several countries also include monetary fines in the penalty.
*Somalia’s Constitution expressly states that the “circumcision of girls is prohibited”. However, there is no national legislation that expressly implements this Constitutional provision, and there are no known instances where FGM offenses have been prosecuted under general criminal provisions. The FGM Bill has been stuck in the legislative process for several years.
What does the ICPD Programme of Action say about FGM?
The Programme of Action of the International Conference on Population and Development (ICPD) recognizes that violence against women is a widespread phenomenon. It states, “In a number of countries, harmful practices meant to control women’s sexuality have led to great suffering. Among them is the practice of female genital cutting, which is a violation of basic rights and a major lifelong risk to women’s health” (para 7.35).
The Programme of Action calls for “Governments and communities [to] urgently take steps to stop the practice of female genital cutting and protect women and girls from all such similar unnecessary and dangerous practices. Steps to eliminate the practice should include strong community outreach programmes involving village and religious leaders, education and counselling about its impact on girls’ and women’s health, and appropriate treatment and rehabilitation for girls and women who have suffered cutting. Services should include counselling for women and men to discourage the practice.” (para 7.40)
Chapter 4, para 4.4 states, “Countries should act to empower women and should take steps to eliminate inequalities between men and women as soon as possible by… eliminating all practices that discriminate against women; assisting women to establish and realize their rights, including those that relate to reproductive and sexual health.” Para 4.9, states, “Countries should take full measure to eliminate all forms of exploitation, abuse, harassment and violence against women, adolescents and children.”
Which international and regional instruments can be referenced for the elimination of FGM?
Most governments in countries where FGM is practiced have ratified international conventions and declarations that make provisions for the promotion and protection of the health of women and girls. For example:
The Universal Declaration of Human Rights proclaims the right of all human beings to live in conditions that enable them to enjoy good health and health care (art. 25). Adopted by the General Assembly of the United Nations on 10 December 1948, the Universal Declaration of Human Rights has five articles which together form a basis to condemn FGM: article 2 on discrimination, article 3 concerning the right to security of person, article 5 on cruel, inhuman and degrading treatment, article 12 on privacy, and article 25 on the right to a minimum standard of living (including adequate health care) and protection of motherhood.
The Convention relating to the Status of Refugees defines who is a refugee, what their rights are, and explains the legal obligations of states. Those fleeing the threat of FGM qualify for refugee status.
The International Covenants on Civil and Political Rights and on Economic, Social and Cultural Rights condemn discrimination on the grounds of sex and recognize the universal right to the highest attainable standard of physical and mental health (art. 12).
The Convention on the Elimination of All Forms of Discrimination against Women requires State Parties to: “take all appropriate measure to modify or abolish customs and practices which constitute discrimination against women” (art. 2f) and “modify social and cultural patterns of conduct of men and women, with a view to achieving the elimination of prejudices and customary and all other practices which are based on the idea of the inferiority or the superiority of either of the sexes” (art 5a).
General recommendation 24 (1999) of the Convention emphasizes that certain cultural or traditional practices, such as FGM, carry a high risk of death and disability and recommends that State parties should ensure laws that prohibit FGM.
General recommendation 14 (1990) recommends State parties take appropriate and effective measures to eradicate FGM; to collect and disseminate basic data on traditional practices; to support women’s organizations that work for the elimination of harmful practices; to encourage politicians, professionals, religious and community leaders to co-operate in influencing attitudes; to introduce appropriate educational and training programmes; to include appropriate strategies aimed at ending FGM into national health policies; to invite assistance, information and advice from the appropriate organization of the United Nations system; and to include in their reports to the Committee, under articles 10 and 12 of the Convention, information about measures taken to eliminate FGM.
The Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment was adopted and opened for signature, ratification and accession by General Assembly resolution 39/46 (entered into force in 1990). The Committee against Torture clearly states in General Comment No. 2 that FGM falls within its mandate. The UN Special Rapporteur on violence against women and the UN Special Rapporteur on torture have both recognized that FGM can amount to torture under this Convention.
The Convention on the Rights of the Child protects against all forms of mental and physical violence and maltreatment (art 19.1); calls for freedom from torture or cruel, inhuman or degrading treatment (art 37a); and requires States to take all effective and appropriate measures to abolish traditional practices prejudicial to the health of children (art 24.3).
The Vienna Declaration and the Programme of Action of the World Conference on Human Rights expanded the international human rights agenda to include gender-based violence, including FGM.
The International Conference on Population and Development Programme of Action calls for governments to “urgently take steps to stop the practice of female genital cutting and protect women and girls from all such similar unnecessary and dangerous practices.”
The Platform for Action of the Fourth World Conference on Women urges governments, international organizations and non-governmental groups to develop policies and programmes to eliminate all forms of discrimination against girls, including female genital cutting.
The United Nations General Assembly passed The Girl Child Resolution (A/RES/51/76), recognizing FGM as a form of “discrimination against the girl child and the violation of the rights of the girl child.”
The African Charter on Human and Peoples’ Rights highlights human rights. Article 4 focuses on integrity of the person, article 5 on human dignity and protection against degradation, article 16 on the right to health, and article 18 (3) on the protection of the rights of women and children.
The Addis Ababa Declaration on Violence against Women serves as an important step towards the formulation of an African charter on violence against women, providing the framework for national laws against FGM. It was adopted at the Council of Ministers during its sixty-eighth Session in July 1998 by the Organization of African Unity (OAU). The Declaration was later endorsed by the Assembly of Heads of State and Governments.
The Banjul Declaration condemns FGM and demands its elimination.
The United Nations Social, Humanitarian and Cultural Committee approved a resolution that calls upon States to implement national legislation and policies that prohibit traditional or customary practices that damage the health of women and girls, including FGM.
The Ouagadougou Declaration of the Regional Workshop on the Fight against Female Genital Mutilation calls for networks and mechanisms to combat FGM.
Key Actions for the Further Implementation of the Programme of Action of the International Conference on Population and Development calls for governments to promote the human rights of women and girls and ensure their freedom from coercion, discrimination and violence, including harmful practices. It also calls for governments to ensure health providers are knowledgeable and trained to serve clients who have been subjected to harmful practices.
Further Actions and Initiatives to Implement the Beijing Declaration and Platform for Action recognizes the progress made in national efforts to ban FGM, and points out that discriminatory attitudes and norms continue to make girls and women vulnerable to gender-based violence, including FGM. It calls for governments to combat and eliminate violence against women.
The European Parliament adopted a resolution on female genital mutilation calling for measures to protect survivors of the practice and urging member states to recognize the right to asylum for women and girls at risk of being subject to FGM.
The Protocol to the African Charter on Human and Peoples’ rights, on the rights of women in Africa, also known as the Maputo Protocol calls for the “elimination of harmful practices.”
United Nations General Assembly adopted The Girl Child Resolution (A/RES/62/140) stating it was “deeply concerned… that female genital mutilation is an irreparable, irreversible harmful practice.”
Commission of the Status of Women passed Resolution 54/7 on ending FGM.
African Union Assembly/AU/Dec. 383(XVII) produced a decision stating that “female genital mutilation (FGM) is a gross violation of the fundamental human rights of women and girls, with serious repercussions on the lives of millions of people worldwide, especially women and girls in Africa.”
The Fifty-sixth session of the Commission on the Status of Women approved a draft decision, “Ending female genital mutilation.” (E/CN.6/2012/L.1) The Secretary-General released a report, “Ending Female Genital Mutilation” summarizing progress made on the implementation of 2010 CSW resolution 54/7.
European Parliament Resolution of 14 June 2012 focused on ending female genital mutilation.
The United Nations General Assembly passed The Girl Child Resolution (62/140), stating it was “deeply concerned… that female genital mutilation is an irreparable, irreversible harmful practice.” The Secretary-General’s Report on the Girl Child also included a special emphasis on FGM (A/64/315, 2009 and A/66/257, 2012).
United Nations General Assembly also passed Resolution 67/146 on intensifying global efforts to eliminate FGM, reaffirmed by Resolution 69/150 in 2014 and 71/168 in 2016.
The Human Rights Council produced a resolution calling for “Intensifying global efforts and sharing good practices to effectively eliminate female genital mutilation.”
FGM is included in the Sustainable Development Goals (SDGs) under Target 5.3, “Eliminate all harmful practices, such as child, early and forced marriage and female genital mutilation.”
Female Genital Mutilation/Cutting: A Statistical Overview and Exploration of the Dynamics of Change. New York, UNICEF, 2013.
Askew I, Chaiban T, Kalasa B, et al A repeat call for complete abandonment of FGM Journal of Medical Ethics 2016;42:619-620
Implementation of the International and Regional Human Rights Framework for the Elimination of Female Genital Mutilation. New York, UNFPA, 2014.
Female Genital Mutilation: A Joint WHO/UNICEF/UNFPA Statement. WHO, 1997.
Eliminating Female Genital Mutilation: An interagency statement. WHO, 2008.
Global Strategy to Stop health-care providers from performing FGM. WHO, 2010.
Female Genital Mutilation: The Practice WHO Information Package. WHO, 1994.
Jacqueline Smith. Visions and Discussions on Genital Mutilation of Girls, An International Survey. 1995.
Nahid Toubia, Caring for women with circumcision. A technical manual for healthcare providers. Rainbo, 1999.
M. de Bruyn. Socio-cultural aspects of female genital cutting. KIT, 1998.
E. Leye, K. Roelens, M. Temmerman. Medical aspects of female genital mutilation. International Center for Reproductive Health, University of Gent. 1998.