Culture, Advocacy and Sexual Practices
Female genital mutilation (FGM) is the partial or complete removal of the female genitals. Different practices are preformed depending on culture and location. The World Health Organization describes four different procedures: a) Clitoridectomy – a process where all or part of the clitoris is removed; b) Excision –a process where the clitoris and some or all of the labia minora which is the inside vaginal lips is removed; c) Infibulation – a process where all of the outside genitalia is removed and then the opening is stitched up to where there is only a small hole left for urine and menstrual flow; d) a process where the girl endures poking, piercing, stretching or cutting of the clitoris and/or labia as well as burning of the exterior vaginal area and or scraping it (“Violence,” 2014, p.1). These procedures or practices are taking place today as they have in the past in many different countries.
FGM is being practiced in 27 African countries, Yemen, and several Asian and Middle Eastern countries. According to Hosken in a 1995 publication, “over 150 million girls and women have been mutilated in Africa and the Middle East” (Yoder, 2013, p. 191). Not much has been done to eradicate this practice until the 1950’s and 1960’s when medical personnel and African activists brought their concerns to the United Nations and the World Health Organization (WHO). Even then, nothing was done until 1979 when a statement was made by WHO that the health of women was threatened due to traditional practices and the governments needed to intervene. This statement went out in Khartoum at a WHO seminar. At this point over the next 10 years people began discussing the situation and making efforts in working to eliminate the practice (Althaus, 1997, p.130).
Numerous studies along with many different forms of education and intervention have been aimed at eradicating this violation to women. One of the largest difficulties is gaining an accurate number of women that have been mutilated or are potential targets for the procedure. The most accurate statistics come from studies done where a physician or medical person does a visual evaluation. Most of the numbers have come from the word of parents, women and girls. This makes it difficult to target areas with the largest population of incidences and develop an educational program that will be convincing and motivating to that particular society (Berg & Denison, 2012). There are many reasons why these societies perform this traditional procedure.
Reasons for practicing female genital mutilation are:
Families feel social pressure that their daughters need to be “circumcised.”
It is often considered a “rite of passage” into adulthood for a girl.
It is believed that it insures premarital virginity and reduces a woman’s sex drive so she stays pure before marriage.
Some believe it increases the value of a girl for marriage.
Some cultures believe it adds to a girl’s femaleness and shyness and presents them as unsoiled and attractive.
Although it is not in any religious text, many believe it is a viable religious practice.
Men in power, leaders in the community, and some medical practitioners have contributed to upholding the practice by verbalizing that it is safe if performed by a trained professional.
It is a cultural tradition.
Some cultures mimic the traditions of their neighbors that are using this practice.
These are the most common reasons why the practice is still continued today (“Female,” 2016, p. 3-4). There are many negative effects from this practice and virtually no positive ones. The dangers these women face and psychological damage they endure is astronomical.
According to the World Health Organization, there are no health benefits and the harm these women and girls endure increases with the brutality of the procedure. The medial issues alone should force these practices to stop. Some of the initial physical problems that may occur are: a) horrible pain; b) extreme bleeding that may not stop; c) swelling of the genital tissue contributing to pain; d) fevers and infections; e) an inability to urinate; f) improper healing of local tissue; g) additional injury to surrounding tissue; h) distress; i) death. After the initial shock and damage is done there can be long-term problems as well:
Some women have trouble urinating and get repeated urinary tract infections.
There can be long-term infections.
Some women have difficulty with their periods and when the procedure includes stitching up of the vaginal area it can be challenging to pass the menstrual blood.
Scar tissue develops and can cause a variety of problems.
Chances of risk in childbirth go up due to complications.
Additional surgeries may be needed in the future to fix complications from the initial mutilation
Many women and girls have psychological troubles from the procedure, they feel disheartened, worried, desecrated and their self-esteem can diminish.
These health hazards are a starting point in advocating against female genital mutilation (“Female,” 2016, p.2-3).
Currently there are many organizations trying to put a stop to this tradition. The United Nations has declared it a violation of human rights. The United States is advocating educational programs, campaigns to empower women and laws to forbid the practice. Amnesty International is trying to convince practitioners to replace the tradition of physical mutilation to a symbolic ceremony sending girls into womanhood (“Violence,” 2014, p.2). Many efforts have been unsuccessful and have faced substantial barriers because the organizations are not addressing the social and economic issues associated with this practice. Outside organizations have created additional resolve in some communities to continue the practice because they view the intervention as a form of cultural imperialism. Laws addressing the discontinuance of the practice are not enforced and are ignored because locals do not want to be told how to live (Althaus, 1997, p.132). The intervention to stop the practice of female genital mutilation needs to take place on international, national, community, family and individual levels.
It is imperative that a professional counselor approach individual families in an understanding and respectful way. The entire community needs to be targeted to make changes. In working with an individual family I would suggest the following strategies:
1) I would address the medical dangers involved in this practice by bringing a medical professional with me on the family visit. We as a team would advise the parents on the inherent risks of the procedure. We would provide understandable literature describing all the potential hazards of participating in this practice.
2) I would take the father aside and discuss how the practice could diminish the pleasure that a future husband would have as well as the possible dangers that the girl and or future children would endure during childbirth.
3) I would explain to the family that we were going to work with their entire community to help them make changes in this societal norm. Being creative and working with the family and community on ideas of how another “rite of passage” ceremony could be initiated to make this an important phase in a young girl’s life for all girls in the community.
4) I would discuss the psychological health of their daughter. How keeping her healthy and eliminating the future possibility of health problems from this potential practice will make her a more fit and worthy wife for a future husband. Mentioning the rights of the girls would be a very delicate matter to discuss and many of these cultures are against the idea and therefore it may not be the best approach at this time (Berg & Denison, 2012, p.143).
These are the strategies I would use with the family. They address the cultural beliefs and hopefully will give the family alternatives to continuing the practice.
It is crucial that outsiders visit these communities and families with the idea that, “to advise is good, but not to order.” A video tape of a drama educating people about the consequences of female circumcision is a great way to set up a forum for discussion on a large scale. This video tape is available from Burkina Faso, whose production was financed through a grant by Research Action and Information Network for Bodily Integrity of Women (Althaus, 1997, p.132). Getting the fathers onboard with changing these customs is a great avenue for making changes. The men will have great influence in determining change. Working with the women in the community and getting women who have experienced health problems to speak with the women and girls will help push them to stand up for themselves. Laws are great but they are only as valuable and the reinforcement of them. The minds of the community must be won in order to make long lasting changes. By targeting individual communities and families change can begin.
References
Althaus, F. (1997). Female Circumcision: Rite of Passage or Violation of Rights? International Perspectives on Sexual and Reproductive Health, 23(3), 130-133. https://www.guttmacher.org/about/journals/ipsrh/1997/09/female-circumcision-rite-passage-or-violation-rights
Berg, R. and Denison, E. (2012). Effectiveness of Interventions Designed to Prevent Female Genital Mutilation/Cutting: A Systematic Review. Studies in Family Planning, 43(2), 135-146.
Female Genital Mutilation. (2016, Feb.). Media Center. http://www.who.int/mediacentre/factsheets/fs241/en/
Violence Against Women: Female Genital Mutilation. (2014). Global Issues: Female Genital Mutilation – Feminist Majority Foundation. http://feminist.org/global/fgm.html
Yoder, P.S., Wang, S. & Johansen, E. (2013). Estimates of Female Genital Mutilation/Cutting in 27 African Countries and Yemen. Studies in Family Planning, 44(2), 189-204.
