Female circumcision or female mutilation refers to a type of traditional practices in which the external female genitalia is cut. In many cases, female mutilation is performed on girls aged from 4 to 12 years in order to enter womanhood. In some cases, however, adult women can also be circumcised, particularly after the first pregnancy. Throughout the history, traditional practitioners of female circumcision have been given the responsibility of circumcising individual girls or groups of peers within their respective communities. However, during recent times, trained health personnel such as midwives, nurses, and physicians perform female circumcision in order to minimize infections among women (Rahman & Toubia, 2000; World Health Organization [WHO], 2012).
Many terms have been used by the indigenous populations when referring to female mutilation. For instance, in Egypt the term tahara has been used over the years. Similarly, the terms tahur and bolokoli have been used in Sudan and Mali respectively. Moreover, terminologies referring to female mutilation vary widely among communities and countries. However, the term “female circumcision” is widely used among the international community to refer to all types of the practice. Since the early 1990s, the term “female genital mutilation-FGM” has been introduced by the World Health Organization (WHO) to refer to the same practice.
Female mutilation is perceived as a violation of women’s rights because it causes physical and psychological injury to their healthy body parts for reasons, which do not have any medical justification. Most importantly, female mutilation violates the rights of children outlined in the Convention on the Rights of the Child. This is because in many cases children do not have any say in the whole matter (Rahman & Toubia, 2000; WHO, 2012).
Nevertheless, African cultural beliefs in relation to female circumcision offer a number of reasons in favor of the practice. First and foremost, female circumcision is a part of the custom and tradition of many communities in Africa. As a result, the practice serves as a rite of transition to womanhood, after which girls are taught social skills such as handling marriages and caring for children. This implies that female circumcision is an act of introducing young girls to their community’s cultural values.
Secondly, female circumcision is believed to play a major role in controlling female sexuality. Being a social construct, female sexuality takes different meanings, which vary among communities. Since virginity and sexual restraint are held highly in most communities, the need to maintain these values justifies female circumcision.
Thirdly, female circumcision is perceived to be highly valued religious practice among Muslim communities in Africa because it guarantees that a girl will remain virgin until marriage. Lastly, in many African communities where most women are circumcised, social pressure plays a major role in promoting the practice. Therefore, circumcision is seen as an important aspect of social conformity and homogeneity (Rahman & Toubia, 2000; Horowitz & Jackson, 1997; Leeming, Madden & Marlan, 2009).
Regardless of the reasons behind female circumcision, communities practice one of the four major types of female mutilation. The most common types of female circumcision include excision (type II) and infibulations (type III). Excision involves the removal of the external female genitalia, specifically, the clitoris and the labia minora, either completely or partially. In some cases, excision may involve the removal of the labia majora. On the other hand, infibulations is a female circumcision procedure, in which vagina is partially sealed and only a narrow opening is left. This entails cutting and repositioning some parts of the external female genitalia, specifically, the inner or outer labia. Moreover, the clitoris may be removed during this procedure (WHO, 2012). Different types of female circumcision have been practiced in approximately 28 African states over the years. As a result, out of 140 million women all over the world who have undergone the procedure of circumcision, about 92 million come from Africa. In many cases, female circumcision in Africa is performed on children aged 10 and below. Moreover, studies show that more than 2 million girls are at risk of undergoing female circumcision annually (WHO, 2012).
Origins of female circumcision in Africa can be found in southern Egypt or somewhere in northern Sudan, where local communities such as Phoenicians, ancient Egyptians, and Hittites embraced the practice. From there, the practice spread across the sub-Saharan and Northeastern parts of Africa to include 28 African countries which practice female circumcision. On the other hand, the information on prevalence of female circumcision in Africa is not well known due to lack of reliable data and little research on the topic. However, some countries including Tanzania, Central African Republic, Mali, Egypt, Ivory Coast, Sudan, and Eritrea present reliable data on female circumcision. Based on these data and other demographic and health surveys, 18 out of the 28 African countries have a female circumcision practice rate of over 50%. Moreover, some countries such as Egypt have a practice rate of approximately 90%, while in other countries such as the Democratic Republic of Congo and Uganda, this rate is approximately 5% (Rahman & Toubia, 2000).
Considering the harmful effects of female circumcision, governments and non-governmental organizations in Africa have embarked on various efforts and initiatives to stop the practice. Therefore, in the beginning of the 20th century colonial administrators and missionaries initiated various programs aimed at stopping female circumcision in African countries such as Kenya and Sudan. These programs, however, were met with anger and frustration from the locals. Subsequently, the fight against female circumcision intensified with the emergence of African Activism movement in the 1960s and 1970s, which included groups of women and doctors. By 1979, the World Health Organization made the first steps towards eliminating the practice by sponsoring various seminars aimed to educate the locals on the harmful effects of female circumcision. With the emergence of strong African leadership in 1990s, international awareness increased significantly leading to recognition of female circumcision as a violation of fundamental human rights. These early efforts culminated into extensive networks of interest groups and organizations, which are currently in place in many African countries and other parts of the world, where African immigrants are residing. Regardless of these efforts and initiatives, female circumcision is still practiced in some parts of Africa. Therefore, there is a need to continue the fight against this practice (Rahman & Toubia, 2000).
Generally, it is widely recognized that female circumcision has no health benefits. Moreover, many health complications are associated with the practice. Among the most notable health complications due to female circumcision are psychological and neurological effects. According to Behrendt and Moritz (2005), circumcised females are more likely to suffer from post-traumatic stress disorder (PTSD) and other memory problems compared to their uncircumcised counterparts. In fact, researchers found out that the prevalence of PTSD and other psychiatric syndromes in circumcised women was higher by 30.4% and 47.9% respectively compared to uncircumcised women. Additional studies have also documented the prevalence of disorders affecting sleep, mood, and cognition among girls and women who have undergone female circumcision. In other cases, circumcised girls and women have reported or shown episodes of fear, bitterness, and suppressed feelings of anger. Moreover, female circumcision negatively impacts self-esteem and self-identity of girls and older women. Lastly, while female circumcision is intended to suppress female sexuality, available studies indicate that women’s sexual experiences are not fully eliminated because other body parts, particularly breasts, can be used for sexual stimulation in circumcised women (Rahman & Toubia, 2000; Leeming et al., 2009).