Female Genital Mutilation/Cutting (FGM/C) is a practice involving the alteration or injury of the female external genitalia for non-medical reasons. Internationally condemned, FGM/C has no known health benefits and is associated with immediate and lifelong physical and psychological consequences. It is not a religious requirement but a deeply entrenched social custom classified as a severe violation of the human rights of girls and women. FGM/C reflects deep-rooted gender inequality and is typically performed on minors, often between infancy and age 15.
Defining Female Genital Mutilation/Cutting (FGM/C)
Female Genital Mutilation/Cutting encompasses all procedures that involve the partial or total removal of the external female genitalia or other injury to the female genital organs for non-medical reasons, as defined by the World Health Organization (WHO). The WHO classifies FGM/C into four distinct types based on the extent of tissue removal and alteration, allowing for a standardized understanding of the procedures.
Type I, known as Clitoridectomy, involves the partial or total removal of the clitoral glans and/or the prepuce (clitoral hood). Type II, referred to as Excision, is the partial or total removal of the clitoral glans and the labia minora (inner folds of the vulva), with or without the removal of the labia majora. This results in a more significant alteration of the external anatomy than Type I.
The most severe form, Type III, is Infibulation, characterized by the narrowing of the vaginal opening. This narrowing is achieved by cutting and repositioning the labia minora or majora to create a covering seal, often involving stitching, and sometimes includes the removal of the clitoral glans. The seal is often reopened for intercourse and childbirth (deinfibulation), and sometimes resealed afterward (reinfibulation).
Type IV is a broad category that includes all other harmful procedures to the female genitalia for non-medical purposes. Examples of Type IV procedures include pricking, piercing, incising, scraping, or cauterizing the genital area. Regardless of the specific type, all forms of FGM/C involve the removal or injury of healthy tissue, and none have any medical justification.
Geographic Distribution and Social Drivers
The practice of FGM/C is concentrated in a geographical belt stretching across the western, eastern, and northeastern regions of Africa, as well as parts of the Middle East and Asia. More than 230 million girls and women alive today are estimated to have undergone the procedure in the 30 countries where it is most prevalent. The custom has also been carried into other continents, including North America and Europe, by diaspora communities.
The continuation of FGM/C is not driven by religious doctrine but by complex, deeply entrenched social and cultural beliefs that vary across communities. One primary social driver is the perceived necessity of the practice for a girl’s marriageability and social acceptance within her community. The procedure is often viewed as a rite of passage into womanhood or a way to ensure adherence to tradition.
The practice is also linked to controlling female sexuality, based on the belief that it preserves a girl’s premarital virginity and ensures modesty or purity. FGM/C operates as a powerful social convention, where conformity is maintained by the reciprocal expectations of community members. Failure to conform may lead to severe social sanctions, including ostracism or reduced family standing, making it difficult for girls to be accepted for marriage.
Higher levels of maternal education and living in urban areas appear to have a protective effect against the practice, while a family history of FGM/C is a common risk factor. The deep-seated nature of these beliefs means that efforts to abandon the practice must address the entire community dynamic, not just the individual, to overcome the pressure for social compliance.
Immediate and Long-Term Health Impact
The health consequences of FGM/C begin immediately upon the procedure and can persist throughout a woman’s lifetime, affecting her physical, sexual, and mental well-being. Immediate risks are often life-threatening, including severe pain, hemorrhage, and neurogenic or hypovolemic shock. Deaths can occur due to excessive blood loss or severe infections such as tetanus or septicemia, especially when the procedure is performed in unsterile conditions by untrained practitioners.
Short-term complications include swelling of the genital tissue, problems with wound healing, and acute urinary issues like pain or urine retention. Damage to the sensitive genital tissue can lead to long-term chronic pain and sexual dysfunction, including pain during intercourse. Scar tissue formation and keloids are common, potentially causing chronic pelvic and vaginal infections.
In the long term, women are at a significantly increased risk for urological problems, such as recurrent urinary tract infections, which can ascend and potentially cause kidney damage. Gynecological issues are also widespread, including menstrual difficulties where blood flow is obstructed, leading to painful menstruation and chronic inflammation. Women who have undergone FGM/C, particularly Type III Infibulation, face severe obstetric complications during childbirth.
Women who have undergone FGM/C have more than double the risk of experiencing prolonged or obstructed labor, postpartum hemorrhage, and a higher likelihood of needing an emergency Cesarean section or instrumental delivery. For instance, women with Type III FGM/C are 70% more likely to suffer hemorrhage during delivery compared to those who have not undergone the procedure.
The practice also carries significant mental health consequences. Survivors are at an almost three-times greater risk of experiencing anxiety or depression, and a 4.4 times higher likelihood of post-traumatic stress disorder (PTSD) compared to unaffected women.
International Law and Prohibition
The international community recognizes FGM/C as a profound human rights violation, establishing a framework for global prohibition and legal action. The practice violates multiple protected rights, including the right to health, bodily integrity, and freedom from violence and discrimination. Several international human rights treaties create legal obligations for governments to eliminate the practice.
The Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW) requires states to take legislative action to abolish customs and practices that discriminate against women, which implicitly includes FGM/C. Similarly, the Convention on the Rights of the Child (CRC) mandates that states take measures to abolish traditional practices that are prejudicial to the health of children. FGM/C is also classified by UN human rights bodies as cruel, inhuman, or degrading treatment, linking it to the prohibition of torture.
Regional instruments, such as the Maputo Protocol in Africa, specifically oblige states to prohibit FGM/C through legislative measures backed by sanctions. This focus on law and policy is intended to prevent the practice in countries where it is prevalent and to protect women and girls at risk. Furthermore, many Western destination countries have enacted domestic legislation to outlaw FGM/C and the act of taking a child abroad for the procedure.
The legal frameworks provide a basis for prosecution and protection, but enforcement remains a challenge in many contexts where the practice is deeply embedded as a social norm. Legal prohibition, coupled with education and community-based interventions, is considered the necessary approach to ensure the long-term abandonment of FGM/C.