When I first heard of female genital mutilation/cutting (FGM/C), I was mortified. Upon reading this UNICEF report, I realized that my previous impressions - that this practice it only occurs in small African villages and affects very few women - were misconceptions. Only now is reliable data on FGM/C available, giving us a clearer picture about the practice, at least for all 29 countries where the practice is concentrated. The report addresses key questions: How many girls and women have undergone FGM/C? Where is the practice most prevalent? How does this concentration vary within countries and across population groups?
This WHO report defines FGM/C as “all procedures involving partial or total removal of the female external genitalia or other injury to the female genital organs for non-medical reasons,” and the Organization categorizes the procedure into 4 types. In 2012, the UN General Assembly unanimously passed a resolution that banned FGM/C. Twenty-six countries in Africa and the Middle East have prohibited FGM/C by law; however, the legislation has proven ineffective. The practice remains widespread in 24 countries where FGM/C is illegal.
There is a social obligation to perform the procedure and the belief that if one does not, then the consequences could include exclusion, criticism, ridicule, stigma or inability to find suitable marriage partners. Relatively few women reported concern over marriage prospects as justification for FGM/C, except in Eritrea and Sierra Leone. The primary benefit cited among men and women was social acceptance and preserving virginity.
In the 29 countries assessed, more than 125 million girls and women alive today have undergone FGM/C, and in the next decade, another 30 million are at risk. There is a large variation in percentages of cut females across the countries. The countries are divided into 5 categories based on their prevalence levels of FGM/C. One in five cut girls live in one country: Egypt.
Variation among regions within a country can be striking, as seen in this map of Senegal (right).
The age at which the procedure is carried out varies across countries. In Somalia, Egypt, Chad and the Central African Republic, at least 80% of cut girls were between 5 and 14 years old. In Nigeria, Mali, Eritrea, Ghana and Mauritania, at least 80% of cut girls were younger than 5. Half of cut girls in Kenya were older than 9 when they had the procedure performed.
Initially, opposition towards the practice focused on health risks, which may have unintentionally encouraged medical professionals to carry out the practice. Traditional practitioners and, more specifically, traditional circumcisers usually perform FGM/C. Though, in countries such as Egypt, Sudan and Kenya, many medical personnel now complete the procedure. In Egypt, for example, 77% of procedures were carried out mostly by doctors, and around half of those procedures were performed at the girl’s home.
Ethnicity still plays a strong role in some countries, as it may be a proxy for shared norms and values. Also, the practice remains to be a physical marker of insider/outsider status. This graph below shows the degree of variability in FGM/C prevalence among ethnic lines by contrasting ethnic groups with the highest and lowest prevalence in countries.
Regarding religion, the practice is most prevalent among Muslim girls and women; however, it is also found among Catholic and other Christian communities. In Niger, for example, 55% of Christian girls and women have undergone FGM/C, compared to 2% of Muslim girls and women.
There is also a rural-urban divide, an income divide, and an education divide. In Kenya, for example, the percentage of girls in rural areas was four times that of those in urban areas. In most instances, daughters of wealthier families were less likely to be cut. In terms of education, the prevalence of FGM/C was highest among daughters of women with no education, and tends to diminish considerably as the mother’s educational level rises. The reason given for these trends is due to the fact that those in urban areas, in wealthier households, or with a higher educational level are more likely to interact with individuals and groups that do not practice FGM/C, shifting normative expectations around FGM/C as a result.
Support for the continuation of FGM/C varies across countries. In most countries (19 out of 29), a majority of girls and women think the practice should end (see graph below). Nevertheless, more than half the female population in Mali, Guinea, Sierra Leone, Somalia, Gambia and Egypt think FGM/C should continue. More men than women favored stopping the practice, especially in Guinea, Sierra Leone and Chad. When fathers were included in the decision-making, their daughters were less likely to be cut.
FGM/C remains a complicated issue, and this report does not give the whole picture; FGM/C is being performed outside these 29 countries, including in Europe and North America. The fight against FGM/C has just begun. Stronger efforts will be essential in order to transform the cultural traditions and expectations ingrained in these societies.
Fortunately, this report gives us a better understanding of FGM/C and, more importantly, an evidence base to begin measuring progress in this area. We know there have already been steps forward in terms of awareness, decreased health risks and legislative bans, but now we can track progress inside countries regarding specific population groups, procedures and attitudes. Hopefully, this evidence base will help us be more effective in promptly eliminating the practice.
*This week's Wikiprogress spotlight is on the e-Frame Net (European Network on Measuring Progress).