Female circumcision, more commonly called female genital mutilation (FGM), refers to any procedure that intentionally alters or injures the external female genitalia for non-medical reasons. An estimated 230 million girls and women alive today have undergone some form of the practice, concentrated across parts of Africa, the Middle East, and Asia. It is recognized internationally as a human rights violation and carries serious health risks ranging from immediate bleeding and infection to lifelong complications.
The Four Types
The World Health Organization classifies FGM into four categories based on what tissue is removed or altered. Type I involves removing part or all of the clitoral hood, sometimes along with the clitoral glans itself. Type II goes further, removing the clitoral glans and the inner lips of the vulva, sometimes along with the outer lips. These two types account for the majority of cases worldwide.
Type III, often called infibulation, is the most extensive form. The inner or outer lips are cut and repositioned to create a seal that narrows the vaginal opening, sometimes to just a small hole. This sealed tissue must later be opened for intercourse and childbirth, sometimes requiring additional procedures. Type IV is a catch-all category for other harmful practices to the genitalia, such as pricking, piercing, or cauterizing.
Who Is Affected and When
FGM is mostly carried out on girls between infancy and age 15, though it occasionally happens to adult women. In some communities, girls are cut as young as newborns or toddlers, specifically to prevent them from being old enough to refuse. The practice is concentrated in western, eastern, and northeastern Africa and in parts of the Middle East and Asia, though migration has made it a global concern. Data exists from 31 countries, and the true worldwide number of affected women is likely higher than the 230 million figure, which only reflects countries where population-level surveys have been conducted.
Immediate Physical Risks
The procedure is frequently performed without anesthesia, using razors, scissors, or other cutting tools. Severe bleeding can occur if the clitoral artery or surrounding blood vessels are cut. Shock, triggered by a combination of pain, blood loss, and infection, is a well-documented complication. Infections spread easily when the same instruments are used on multiple girls or when healing takes place in unsanitary conditions. Deaths occur from hemorrhage and from infections including tetanus.
Long-Term Health Consequences
The complications of FGM do not end with the initial healing. Many women experience chronic pain, recurrent urinary tract infections, and menstrual problems caused by obstructed flow, particularly after infibulation. Scar tissue and keloids can form at the wound site, causing ongoing discomfort. Sexual intercourse can be painful or impossible without further cutting in women who have undergone Type III.
Childbirth carries elevated risks for women with FGM. Scar tissue does not stretch like normal skin, increasing the likelihood of prolonged labor, tearing, and emergency intervention. The psychological toll is also significant. Studies in the UK estimated that psychological problems and long-term complications together account for roughly £100 million in annual healthcare costs in that country alone. Globally, the healthcare burden of treating FGM complications runs to an estimated $1.4 billion per year, a figure projected to reach $2.1 billion by 2047 if trends continue.
Why It Persists
FGM is driven by a web of social pressures rather than a single reason. In many communities, it is tied to ideas about sexual purity, marriageability, and what it means to be a proper woman. Families who do not have their daughters cut may face social exclusion, and girls who haven’t undergone FGM can be considered unmarriageable. In some settings, religious texts are cited as justification, though no major religion prescribes the practice. The procedure is typically planned and carried out by women in the community but receives tacit support from men.
One of the more concerning recent trends is medicalization. About one in four FGM survivors worldwide, roughly 52 million women, were cut by a healthcare provider rather than a traditional practitioner. Among adolescents aged 15 to 19, that figure rises to 34 percent, compared to 16 percent among women aged 45 to 49, suggesting the trend is accelerating. In Egypt and Sudan, nearly 8 in 10 girls are cut by medical personnel. Medicalization does not make FGM safe. It can reduce some immediate risks like infection, but it does not prevent the long-term physical, sexual, and psychological harm.
Legal and Human Rights Status
A 2008 UN interagency statement formally defined FGM as a violation of human rights, a form of gender-based discrimination, and a form of violence against girls. The practice conflicts with several major international frameworks: the Universal Declaration of Human Rights (which guarantees the right to life, liberty, and security), the Convention on the Elimination of All Forms of Discrimination against Women, and the Convention on the Rights of the Child. Because it involves cutting healthy tissue without medical necessity and can lead to severe consequences for physical and mental health, FGM also violates the right to the highest attainable standard of health.
Many countries where FGM is practiced have passed laws banning it, and it is illegal in most Western nations as well. The UN Sustainable Development Goals include a specific target (5.3) to eliminate all harmful practices, including FGM. Progress is measurable but slow. In many regions, laws alone have not been enough to change deeply rooted social norms. Community-led education programs that engage both men and women have shown the most promise in reducing prevalence, particularly when they address the social incentives that keep the practice alive rather than simply criminalizing it.