Female genital mutilation (FGM) comprises all procedures that involve partial or total removal of the external female genitalia, or other injury to the female genital organs for non-medical reasons.
The practice is mostly carried out by traditional circumcisers, who often play other central roles in communities, such as attending childbirths. However, more than 18% of all FGM is performed by health care providers, and the trend towards medicalization is increasing.
FGM is recognized internationally as a violation of the human rights of girls and women. It reflects deep-rooted inequality between the sexes, and constitutes an extreme form of discrimination against women. It is nearly always carried out on minors and is a violation of the rights of children. The practice also violates a person's rights to health, security and physical integrity, the right to be free from torture and cruel, inhuman or degrading treatment, and the right to life when the procedure results in death.
Female genital mutilation is classified into four major types:
No health benefits, only harm
FGM has no health benefits, and it harms girls and women in many ways. It involves removing and damaging healthy and normal female genital tissue, and interferes with the natural functions of girls' and women's bodies.
Immediate complications can include severe pain, shock, haemorrhage (bleeding), tetanus or sepsis (bacterial infection), urine retention, open sores in the genital region and injury to nearby genital tissue.
Long-term consequences can include:
Who is at risk?
Procedures are mostly carried out on young girls sometime between infancy and age 15, and occasionally on adult women. In Africa, more than three million girls have been estimated to be at risk for FGM annually.
More than 125 million girls and women alive today have been cut in the 29 countries in Africa and Middle East where FGM is concentrated (1).
The practice is most common in the western, eastern, and north-eastern regions of Africa, in some countries in Asia and the Middle East, and among migrants from these areas.
Cultural, religious and social causes
The causes of female genital mutilation include a mix of cultural, religious and social factors within families and communities.
In December 2012, the UN General Assembly adopted a resolution on the elimination of female genital mutilation.
In 2010 WHO published a "Global strategy to stop health care providers from performing female genital mutilation" in collaboration with other key UN agencies and international organizations.
In 2008 WHO together with 9 other United Nations partners, issued a new statement on the elimination of FGM to support increased advocacy for the abandonment of FGM. The 2008 statement provides evidence collected over the past decade about the practice. It highlights the increased recognition of the human rights and legal dimensions of the problem and provides data on the frequency and scope of FGM. It also summarizes research about on why FGM continues, how to stop it, and its damaging effects on the health of women, girls and newborn babies.
The new statement builds on the original from 1997 that WHO issued together with the United Nations Children’s Fund (UNICEF) and the United Nations Population Fund (UNFPA).
Since 1997, great efforts have been made to counteract FGM, through research, work within communities, and changes in public policy. Progress at both international and local levels includes:
Research shows that, if practicing communities themselves decide to abandon FGM, the practice can be eliminated very rapidly.
FGM in Egypt
The practice of FGM/C is Egypt is quite prevalent. However, recent evidence has shown that the practice is declining among girls and women of younger age. The recent 2008 Demographic Health Survey in Egypt (EDHS) reported that the FGM/C prevalence rate among women from ages 15-49 is 91.1 percent, but 74 percent among girls age 15-17. The recent report indicated that a decline is expected over the next fifteen years among girls age 15-17, reaching a level of 45 percent.
In 2006, another representative study was conducted by the Ministry of Health (MoH) among school girls aged 10-18 in 10 selected governorates measuring the prevalence of FGM/C among them. The study concluded that 50 percent of the girls are circumcised and that the percentage of circumcision is higher among the daughters of non-educated mothers (64.7 percent) as opposed to the daughters of women who attended university (22.3 percent).
The 2008 EDHS has also shown that a mother’s level of education, residency and economic status are important variables. For example, urban women are less likely to be circumcised than rural women (EDHS, 2000, 2005 & 2008). The likelihood of circumcision drops by education level and wealth quintile. The 2008 EDHS reports that 31 percent of girls in the highest wealth quintile are expected to be circumcised by the age of 18 compared with 73 percent of girls in the lowest wealth quintile.
In June of 2008, the Egyptian Parliament agreed to criminalize FGM/C in the Penal Code, establishing a minimum custodial sentence of three months and a maximum of two years, or an alternative minimum penalty of 1,000 Egyptian pounds (LE) and a maximum of 5,000 LE.
Also, the new Child Law included the formation of Child Protection Committees (CPC) at different national levels with duties to identify, support and monitor children at risk of neglect and abuse, including girls at risk of circumcision.
Furthermore, to assist in the enforcement of legislation, Egypt hosted in 2008 a regional meeting entitled 'Cairo Declaration+5'. This conference is a follow-up to the 2003 meeting that also took place in Cairo and resulted in an important legal document on FGM/C titled 'The Cairo Declaration for the Elimination of Female Genital Mutilation'. The main objectives of the conference were to follow up on the recommendations of the pervious conference and to launch an international campaign aimed at rekindling world-wide attention on FGM/C.
The Egyptian Ministry of Health (MoH) issued in 2007 a ministerial decree (271) closing a loophole in the previous 1996 decree by banning everyone, including health professionals, from performing FGM/C in governmental or non-governmental hospitals/clinics.
In 2007, Grand Mufti Ali Gomaa’s issued a 'Fatwa' condemning FGM/C and the Azhar Supreme Council for Islamic Research issued a statement explaining that FGM/C has no basis in the core Islamic Sharia or any of its partial provisions.
In September 2012, Egyptian gynecologists & obstetricians union launched a statement declaring that FGM/C is not a medical procedure & is not included in any medical curriculum else as a practice that should be prevented consequently law doesn’t offer protection to physicians who practice it.
The statement also emphasized on the fact that there is no medical indication, health or behavioral benefits of it, on the contrary it leads to psychological & reproductive complications for women on the long run which might stay lifelong with them in addition to the medical complications that might happen during it’s practice.
Fourteenth of June is the national Zero FGM tolerance day commemorating Bedour Ahmed Shaker from Maghagha in Menya governorate who died due to FGM on the hands of a physician, Thousands of girls are still affected by what killed Bedour.
Sohair Elbatee is another girl who died of FGM in June 2013 in Aga Dakahlya, Her case has been reopened & the general Attorney transferred the Charged Father & Physician to the criminal court as the first case of prosecution on FGM.