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Female Genital Cutting. Martin Donohoe. Female Genital Cutting. 135 million women affected worldwide (2 million girls/year) Most in Africa (e.g. 98% of women in Somalia, 80% in Egypt, 50% in Kenya) Outlawed in Egypt - 2007 Rare in Asia, Western hemisphere. Female Genital Cutting.

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Female Genital Cutting

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female genital cutting2
Female Genital Cutting
  • 135 million women affected worldwide (2 million girls/year)
    • Most in Africa (e.g. 98% of women in Somalia, 80% in Egypt, 50% in Kenya)
      • Outlawed in Egypt - 2007
    • Rare in Asia, Western hemisphere
female genital cutting3
Female Genital Cutting
  • All socioeconomic strata and all major religions
  • Reasons: gender/cultural identity, hygiene, fertility, child survival, maintain virginity, enhance male sexual pleasure
  • Formerly used in U.S. and U.K. as treatment for hysteria (“floating womb”), epilepsy, melancholy, lesbianism, and excessive masturbation
female genital cutting4
Female Genital Cutting
  • Has been called female genital mutilation
  • Not female circumcision
    • i.e., male equivalent would be penectomy
  • Ranges from clitoridectomy to total infibulation (removal of clitoris and labia minora, removing labia majora and stitching rough edges together, and leaving a small opening posterior for urine and menstral blood)
female genital cutting5
Female Genital Cutting
  • Represents cultural control of women’s sexual pleasure and reproductive capabilities
    • surgical “chastity belt”
    • c.f. virginity exams by physicians in Turkey
female genital cutting6
Female Genital Cutting
  • Type I - removal of clitoris
  • Type II - removal of clitoris and part of labia minora (80% of procedures)
  • Type III - modified infibulation - 2/3 of labia majora sewn together
  • Type IV - total infibulation – labia majora cut, rough edges sewn together (15% of procedures)
female genital cutting7
Female Genital Cutting
  • Procedures sometimes include:
    • Incisions/scarification of perineum and vaginal walls
    • Introduction of corrosives and herbs into vagina
female genital cutting10
Female Genital Cutting
  • Most commonly carried out between ages 4 and 10
    • physicians perform about 12% of operations
    • Midwives, barbers, relatives
  • Often done under non-sterile conditions and without anesthesia
female genital cutting complications sequelae



painful neuromas




decreased sexual responsiveness




Female Genital CuttingComplications/Sequelae
management of female genital cutting
Management of Female Genital Cutting
  • Sensitivity/understand cultural identity issues
  • Deinfibulation
  • Immigration Issues
female genital cutting13
Female Genital Cutting
  • UN, WHO, and FIGO have condemned
  • Illegal to perform in U.S. under child abuse statutes
    • ?“cultural imperialism”?
cultural imperialism
?Cultural Imperialism?
  • Other outlawed “cultural practices”:
    • Slavery
    • Polygamy
    • Child labor
    • Denial of appropriate, life-saving medical care to sick children
  • Adams KE. What's Normal: Female Genital Mutilation, Psychology, and Body Image. JAMWA 2004;59(3):168-170. Available at http://jamwa.amwa-doc.org/index.cfm?objectid=2A3A132A-D567-0B25-5985AC5574B1C538
  • Donohoe MT. Individual and societal forms of violence against women in the United States and the developing world: an overview. Curr Women’s Hlth Reports 2002;2(5):313-319.
  • Donohoe MT. Violence and human rights abuses against women in the developing world. Medscape Ob/Gyn and Women’s Health 2003;8(2): posted 11/26/03. http://www.medscape.com/viewarticle/464255
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