Female circumcision refers to any procedure that intentionally removes or injures part of the external female genitalia for non-medical reasons. International health organizations, including the World Health Organization and UNICEF, classify it as female genital mutilation (FGM) because, unlike male circumcision, it removes functional tissue with no health benefits and carries serious risks. More than 230 million girls and women alive today have undergone some form of FGM worldwide.
Why the Term “Mutilation” Is Used
You may see the terms “female circumcision,” “female genital cutting,” and “female genital mutilation” used interchangeably. Health authorities deliberately adopted the word “mutilation” to distinguish these practices from male circumcision, which removes a fold of skin (the foreskin) but leaves the functional anatomy of the penis intact. Female procedures, by contrast, typically remove or damage tissue directly responsible for sexual sensation, particularly the clitoral glans. The shift in language reflects a medical and human rights consensus that the practice causes harm with no corresponding benefit.
The Four Types of FGM
The WHO classifies FGM into four types based on how much tissue is removed or altered. The severity varies widely, but all types carry health risks.
Type I
This involves partial or total removal of the clitoral glans, the visible, highly sensitive part of the clitoris, and sometimes the clitoral hood (the small fold of skin that covers it). In its mildest form, only the hood is removed. In its more extensive form, the clitoral glans itself is cut away along with the hood.
Type II
Type II goes further, removing the clitoral glans along with the labia minora (the inner folds of the vulva). In some cases, the labia majora (the outer folds) are also partially or fully removed. This is sometimes called “excision” and is one of the most commonly practiced forms.
Type III
Known as infibulation, this is the most severe form. It involves narrowing the vaginal opening by cutting and repositioning the labia to create a seal, often leaving only a small hole for urine and menstrual blood to pass through. The clitoral glans and inner labia may be removed as part of the process. Women with Type III FGM typically need the seal cut open for sexual intercourse and childbirth, and the opening is sometimes restitched afterward.
Type IV
This is a catch-all category for other harmful procedures to the genitalia that don’t fit the first three types, including pricking, piercing, scraping, or cauterizing genital tissue.
Immediate Health Risks
FGM is frequently performed on girls between infancy and age 15, often without anesthesia and with non-sterile instruments. The immediate dangers include severe bleeding (hemorrhage), shock from pain or blood loss, and urinary retention or intense pain during urination as wounded tissue swells. Infections, including tetanus, can develop rapidly. In the most serious cases, uncontrolled bleeding or infection leads to death.
Long-Term Physical Effects
The consequences extend far beyond the initial procedure. Scar tissue can cause chronic pain, especially during menstruation and intercourse. Recurrent urinary tract and vaginal infections are common because normal anatomy has been disrupted. Women with Type III FGM face additional complications: menstrual blood can become trapped behind the sealed tissue, and cysts or abscesses may form along scar lines.
During childbirth, FGM increases the risk of prolonged labor, tearing, instrumental delivery (such as the use of forceps), and postpartum hemorrhage. These risks are highest with Type III but are present across all types. For women with infibulation, the sealed tissue must be surgically opened before delivery, adding another layer of medical intervention.
Psychological and Sexual Impact
A systematic review published in The Lancet found that women and girls who have undergone FGM experience significantly higher rates of depression, anxiety, and post-traumatic stress disorder compared to those who have not. Depression is the most commonly reported mental health outcome. Sleep disorders, chronic anxiety, and what researchers call somatization (experiencing psychological distress as physical symptoms like headaches or stomach pain) are also prevalent.
Because the clitoral glans is the primary source of sexual pleasure for most women, its removal or damage often affects sexual function. Many women with FGM report reduced sensation, pain during intercourse, or difficulty with arousal and orgasm. The degree of impact depends on how much tissue was removed and whether scarring has complicated healing.
Where and Why FGM Occurs
FGM is concentrated in parts of Africa, the Middle East, and some communities in Asia, though migration has made it a global concern. It is practiced across religious lines. No major religion requires it, but it is sometimes justified on cultural or religious grounds. In many communities, it is tied to ideas about purity, marriageability, or controlling female sexuality. Social pressure is a powerful driver: families may feel that not cutting their daughters will make them outcasts or unmarriageable.
FGM is illegal in most countries where it is practiced and in virtually all Western nations. Despite this, enforcement remains inconsistent, and the practice continues in many regions. UNICEF’s most recent data shows the global number of affected women and girls has risen by 30 million over the past eight years, largely due to population growth in countries where FGM is common.
Medical Care for Women With FGM
Women who have undergone FGM can receive care that addresses many of the physical complications. For those with Type III, a surgical procedure called defibulation opens the sealed tissue, which can relieve urinary and menstrual problems and make intercourse and childbirth safer. Scar tissue revision and treatment for chronic infections are also available in many healthcare settings. Psychological support, including trauma-focused therapy, can help address the lasting emotional effects. Reconstructive surgery for the clitoris exists but is still relatively new, and results vary.