ISSM Issues Policy Statement On Female Genital Cutting

The International Society for Sexual Medicine (ISSM) has issued a public policy statement on female genital cutting (FGC).

“Female genital cutting should be condemned in the strongest possible terms and should not be tolerated by any healthcare practitioner, any agency responsible for public health, or any government,” the statement says.

Female genital cutting (sometimes called female genital mutilation) is a cultural practice that involves injury to the female genitalia. It can range from a small skin cut to complete removal of genital organs.

FGC is common in western, eastern, and northeastern Africa and in some Asian and Middle Eastern countries. It is also found among immigrants in other areas, such as the United States, Europe, and Australia.

The World Health Organization (WHO) classifies four different types of FGC:

Clitoridectomy. Partial or total removal of the clitoris and/or the prepuce (the fold of skin that surrounds the clitoris).

Excision. Partial or total removal of the clitoris and the labia minora (sometimes including the labia majora).

Infibulation. Narrowing the vagina with a covering seal, which is formed by cutting the labia and bringing tissue together. In some cases, the clitoris is removed. Some women have their vaginas stitched almost completely shut, with small openings for urine and menstrual blood.

Other. Procedures performed on the female genitalia for non-medical reasons, such as pricking, piercing, and cauterizing.

The WHO estimates that 140 million girls and women worldwide have had their genitals cut.

Usually, cutting occurs sometime between infancy and the age of 15. In many cultures, FGC is a rite of passage and a way for parents to ensure that their daughters are prepared for marriage. Some cultures believe FGC reduces a woman’s libido and keeps her “pure.” FGC is also associated with ideas of femininity and modesty in some communities.

Some believe that FGC is mandated by certain religions, but no religious texts support the practice.

FGC has no health benefits and many harmful consequences. Most FGC rituals are conducted by traditional practitioners using scissors, knives, or razor blades. Often, equipment is not sterilized, which increases the risk of wound infection and the transmission of other infections like hepatitis and HIV.

Bleeding, hemorrhaging, and sepsis are frequent short-term complications of FGC. Most girls are not given anesthesia and experience intense pain. Psychological trauma is common as well.

FGC has serious long-term complications, many of which interfere with women’s daily functioning. They may have trouble urinating and menstruating and develop infections as a result. Many women are unable to have complete gynecological exams because of the extent of the cutting.

Sexual health is often compromised. Sex is painful for many women who have had FGC, as the scars left in the vagina can become cysts or abscesses. For women who have had their vaginas stitched shut, there may be additional surgeries. The vagina may need to be opened again for intercourse and childbirth. In some cultures, the vagina is open and closed repeatedly during a woman’s childbearing years. Some women become infertile.

Infants born to women who have had FGC are at high risk for low birth weight, infection, neonatal death, and stillbirth.


Resources

International Society for Sexual Medicine

“Public Policy Statement – Female Genital Cutting”
(April 18, 2012)
http://www.issm.info/news/public-policy-statement


U.S. Department of Health and Human Services, Office on Women’s Health

“Female Genital Cutting”
(Last updated December 15, 2009)
http://www.womenshealth.gov/publications/our-publications/fact-sheet/female-genital-cutting.pdf


World Health Organization

“Classification of female genital mutilation”
(No date given; classification from 2008)
http://www.who.int/reproductivehealth/topics/fgm/overview/en/index.html#

“Female genital mutilation”
(Fact Sheet – February 2012)
http://www.who.int/mediacentre/factsheets/fs241/en/index.html


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