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Apr 03 2014

Female Genital Mutilation – An Expansion to the Primer

This is not safe for work, this is not safe for life, this is not safe in general. The following contains images of FGM and vaginas. If you do not wish to see these then please do not read further.

What follows is an image and a discussion on Female Genital Mutilation. It is a complication of the procedure.

When we discuss why a medical condition should be made public particularly of genitals we forget that while people are squeamish, many will say that the usage of squeamish images is insulting to the victims.

How on earth are we to discuss a problem. How are we to discuss a procedure. How are we to discuss the damage caused.

How are we to do ANY of these things without knowing what it looks like? Hence my warning.

To begin with, let’s discuss what constitutes FGM.

No Jokes! Shame on You!
The fourth type isn’t depicted because it’s mostly voluntary or medical… Mostly

There are four classifications of FGM according to the WHO.

Type I – Clitirodectomy. It is the removal of the clitoris and the clitoral hood. Normally? There is only one indication for this procedure medically. Metastasis of cancer to the region may require removal of the clitoris.

Type II – Includes the type I procedure and removal of the inner labia.

Type III – Is called infibulations. It involves removal of the clitoris, labia and fusion of wound leaving a small hole for passage of urine and blood which is reopened for childbirth and intercourse.

Type IV – Miscellaneous acts such as symbolic pricking, piercing of clitoris and labia, cauterisation and cutting into the vagina to widen it or usage of corrosives to tighten the vagina. These are mainly considered medical practices and are done for a variety of conditions ranging from body piercing and fashion to disorders like sexual dysfunction due to a narrow vagina, vaginismus due to damage during childbirth, cancer and some plastic surgery. It is generally voluntary though some exceptions exist.

Type I and II are the most common. Type III is predominant in Sudan, Somalia and Djibouti. Type IV is seen across the world including voluntary FGM as seen in body modification and piercing circles in the west.Now I know I am going to get a lot of flak for pointing out that body modification and piercing circles undergo Type IV FGM, but this is the WHO classification of the act rather than mine. It’s also important to point out the difference between body modification and piercings where an individual volunteers to have the piercing when compared to someone who is forced or coerced into having it done. I have no issue with volunteers, it’s your body and if your happiness lies in putting metal through your genitals then godspeed you fancy bastards! The reason for it’s utilisation in this context is that NORMALLY in the context of the west Type IV is voluntary but there are some cultures where the practice is compulsory and is not as radical as Type I, II or III. In Malaysia for example Type IV is more involuntary than in the west.

But for these women it isn’t a choice. There is a cultural, social and religious peer pressure to get the procedure done.

This is seen as a cultural rite of passage. Religion merely co-opted it to fit to the local culture. In fact there are big drives with local Imams and Priests to stamp it out but it’s not succeeding because it’s a social pressure. This is how things have been done for thousands of years, it’s not going to vanish overnight because some man in a stupid hat says so.

There has to be a major cultural change and that’s hard to create because people simply don’t see what’s wrong with this.

Who do you think did the procedure? People who loved and cared for the young girl. This was not done out of spite but a genuine belief that this will help the young girl. Her mother and grandmother would have been proud and treated her like an adult. She may have cried during it but she probably would have been proud too.

That is the problem, you are fighting a practice that is blatantly harmful in our eyes that they don’t recognise because that’s the norm for them.

Not only does it defend a practice steeped in superstition and culture as a good thing, it also does so by invoking a divine mandate followed by a billion people across the world that isn’t prone to criticism and honest debate.Let’s face it, Islam does not like debate. When Christians complain that Muslims get a free ride from atheists, it’s mainly because muslims do have a small but significant minority who don’t listen to reason and who are quite happy to kill someone for their perceived involvement in an attack on their faith. It’s extremely hard to criticise someone who threatens you with death and acts on it. We see here a marriage of the worst attitudes of faith and woo. The perceived medical benefit married to the blind faith in a book written by someone who could not fathom our knowledge and understanding. This is deadly beyond comparison and it shows. The 1997 figure for FGM states that roughly 135 million women had undergone the procedure. The number certainly hasn’t gone down since there isn’t a big drive to halt the procedure. We can say a lot of things about the British Colonial period. A lot of horrible things were done by Great Britain across the world. But as most Indians will realise (even if they don’t like admitting it) Great Britain created India as a solid unified body. Without them? India would be a balkanised series of tiny countries and not the rising giant it is today. The erstwhile masters unknowingly created nationalism, they gave India the tools to set itself free from all masters be they gods or men even if Indians do forget that sometime. And one of the things the British did in India that I am sure most Indians are thankful for was to give a legal impetus to the Hindu anti-sati reforms. A coalition of Indian reformers and British lawmakers helped stamp out the practice. However, we see a similar move in Africa where in Kenya the British attempted to stamp out the practice through the church and law resulting in revolutions as many kenyans perceived a british plot to destroy local culture  to the point where the practice was actively defended as a Kenyan cultural issue. So what we see here is a genuinely destructive practice that people do consider unnecessary and bad but still do because it’s a symbol of culture.

So opposition to the practice has traditionally resulted in people being considered “un-African” or would cause the women who opposed it to become social pariah.

And it’s not absent in the west. Over 20,000 children are at risk each year in the UK and 65,000 women are believed to be living with the consequences of FGM. And this is the tip of the iceberg since the nature of FGM and the ideology makes it a hidden issue that is unlikely to see the light of a doctor’s office unless severe problems occur. Many of these kids have the procedure done over the summer holidays during trips abroad. There is also a rising fear that there are such ceremonies in the UK.

There is absolutely no health benefit to doing this this causes nothing but detriment to the women.

Immediate effects

  • Severe Pain
  • Shock
  • Haemorrhhage
  • Wound infections ranging from gangrene requiring major amputation and removal of the vagina to tetanus due to poor hygiene of blades. Septicaemia has occurred as well resulting in death. Other diseases include HIV and Hepatitis which can be transferred in mass ceremonies.
  • Urinary incontinence
  • Recto-Uterine/Vesico-Uterine/Vesico-Vaginal/Recto-Vaginal fistulae
  • Injury
  • Adhesion
  • Urinary retention
  • Trauma

This can lead to death.

Long-term consequences

  • Vaginal, Pelvic and Urethral Infections
  • Amenorrhea and Irregular Periods
  • Retention/Incontinence of Urine
  • Renal Failure
  • Infertility
  • Vaginosis
  • Scar Tissue
  • Painful Intercourse
  • Pregnancy complications
  • Improper dilation during pregnancy
  • Foetal and Maternal Deaths
  • Loss of pleasure during sex
  • PTSD
  • Low Libido/Anxiety
  • Birth Trauma
  • Adhesion may require late surgery

Now in particular we have to discuss the complications with pregnancy.

The narrowed vagina makes it harder for delivery and causes the woman to need to bear down harder. There is more tearing of tissue too and so the risk of haemorrhage occurs. And in any case, blood loss to a pregnant lady is often a major problem so correction of haemorrhage takes priority. And the “correction” may require restoration to a FGM state (think of the FGM state as the normal state and the state at which haemostasis occurs).

This is the problem with the first FGM trial in the UK. The doctor seems to have restored a woman to that state in order to save her life. One hopes that if this is the case, the doctor in question is found not guilty and his career restored.

Things take time, things take money, things take effort, things take manpower, things take brave people making changes.

There are very few of these taking place. For those who wonder why Islam isn’t making any changes, You may as well ask why Christians are not eradicating the practice too. The practice is not religious but cultural. Religion just tries to excuse it to ingratiate itself with the local culture.

It takes a serious concerted and universal effort to get rid of this. It’s not just Mullahs and Imams, you need to get the health personnel, teachers and cutters themselves onboard with stopping the practice.

The pressures are both female and male. Men want “virgins” and this is a virgin guarantee. It is also a major rite of passage and is done by women. It’s not treated as a terrifying time in a child’s life but as a gigantic party involving the women.

So we have 3 parties to deal with. The Men who expect this. The Women who expect this. And the cutters. To destroy the practice we first need education where we can point out the ills of FGM. In addition we have to start changes in the expectations of men and the utilisation of women from the area to make changes and make NOT cutting a social option. Finally the cutters need to be taken on board and be given an alternative method of survival because at the moment it is in their vested interest to keep cutting and they have a better grasp of the culture and a more solid role in the social network in maintaining the culture of FGM. We need to make it monetarily superior to oppose FGM and utilise their role to eliminate their own practice. We must subvert the mechanism and the industry.

The families who wish this need to realise that this is a horrible thing and that they should not expect this to be the norm anymore. Currently people treat the issue as if it were a pierced ear.

That’s how you kill FGM, not by faffing about blaming Muslims. Because that’s not how change happens. That’s how you get to feel superior about yourself.

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