Female Genital Mutilation (FGM) is defined, by the World Health Organization (WHO), as “all procedures that involve partial or total removal of the external female genitalia, or other injury to the female genital organs for nonmedical reasons”. The term FGM is preferred by WHO and United Nations in order to convey the irreparable physical and psychological damage done to girls and women.  

In 1997, World Health Organization (WHO) classified FGM into four types, namely, Type I (Clitoridectomy); Type II (Excision); Type III (Infibulation); and Type IV (Unclassified).  These types, which were further subdivided in 2008 by WHO, are all practiced in Nigeria.  The four Types of FGM and their subtypes are described in 7a-d.  

FGM Type I: partial or total removal of the clitoris and/or the prepuce (Clitoridectomy).  

Subdivisions of FGM Type I are: FGM Type Ia, removal of the clitoral hood or prepuce only and FGM Type Ib, removal of the clitoris with the prepuce.

FGM Type II: partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora (excision).

Subdivisions of FGM Type II are:  IIa, removal of the labia minora only; IIb, partial or total removal of the clitoris and labia minora; and IIc, partial or total removal of the clitoris, labia minora and labia majora.

FGM Type III: narrowing of the vaginal orifice with creation of a covering seal by cutting and appositioning the labia minora and/or the labia majora, with or without excision of the clitoris (infibulation).

Subdivisions of FGM Type III are: FGM Type IIIa, removal and apposition of the labia minora; and FGM Type IIIb, removal and apposition of the labia majora.

Reinfibulation is covered under this definition. This is a procedure to recreate an infibulation, for example after childbirth when defibulation is necessary.

Type IV: unclassified – All other harmful procedures to the female genitalia for non-medical purposes.  It includes:

Piercing or incision of clitoris and/or labia.

Cauterisation by burning of clitoris and surrounding tissues;

Scraping (angurya cuts) of the vaginal orifice or Cutting (gishiri cuts) of the vagina;

Introduction of corrosive substances into the vagina to cause bleeding or Herbs into the vagina with the aim of tightening or narrowing the vagina.

FGM Type IV also includes the practice of “massaging” or applying petroleum jelly, herbal concoctions or hot water to the clitoris to desensitize it or pushing it back into the body, which is common in many parts of Nigeria, especially Imo State.

It is estimated that over 200 million girls and women worldwide are living with or at risk of suffering the associated negative health consequences of FGM.

Every year 3 million girls and women are at risk of FGM and are therefore exposed to the potential negative health consequences of this harmful practice. The procedure of FGM is painful and traumatic, and is often performed under unsterile conditions by a traditional practitioner who has little knowledge of female anatomy or how to manage possible adverse events.

FGM has no known health benefits. Moreover, the removal of or damage to healthy genital tissue interferes with the natural functioning of the body and may cause immediate and long-term health consequences.  

The “Immediate & Short term complications” of FGM are 1) severe pain and injury to tissues; 2) haemorrhage (bleeding); 3) haemorrhagic shock; 4) infection and septicaemia; 5) genital tissue swelling; 6) acute urine retention; and 7) fracture of bones.

The “long-term complications of FGM” are 1) chronic vulvar pain; 2) clitoral neuroma; 3) reproductive tract infections; 4) menstrual problems; 5) urinary tract infections; 6) painful or difficult urination; 7) epidermal inclusion cysts; and 8) keloids.  

In 2006, WHO study group analysed the obstetric risks associated with FGM and concluded that women living with FGM are significantly more likely than those who have not had FGM to have adverse obstetric outcomes such as 1) Caesarean section; 2) Postpartum haemorrhage (Postpartum blood loss of 500 ml or more); 3) Episiotomy; 4) Prolonged labour); 5) Obstetric tears/lacerations; 6) Instrumental delivery; 7) Difficult labour/dystocia; 8) Extended maternal hospital stay; 9) Stillbirth and early neonatal death; and 10) Infant resuscitation at delivery.

Given that some types of FGM involve the removal of sexually sensitive structures, including the clitoral glans and part of the labia minora, some women may experience the following 1) Dyspareunia (pain during sexual intercourse); 2) Decreased sexual satisfaction; 3) Reduced sexual desire and arousal; 4) Decreased lubrication during sexual intercourse; 5) and Reduced frequency of orgasm or anorgasmia. 

For many girls and women, undergoing FGM can be a traumatic experience that may leave a lasting psychological mark and cause a number of mental health problems, which include 1) Post-traumatic stress disorder (PTSD); 2) Anxiety disorders; and 3) Depression.

The practice of FGM is prevalent in 30 countries in Africa and in a few countries in Asia and the Middle East, but also present across the globe due to international migration  

FGM is practiced for a variety of sociocultural reasons, varying from one region and ethnic group to another. The primary reason is that it is part of the history and cultural tradition of the community.

In many cultures, FGM constitutes a rite of passage to adulthood and is also performed in order to confer a sense of ethnic and gender identity within the community. In many contexts, social acceptance is a primary reason for continuing the practice.

Other reasons for practicing FGM include safeguarding virginity before marriage, promoting marriageability (i.e. increasing a girl’s chances of finding a husband), ensuring fidelity after marriage, preventing rape, providing a source of income for circumcisers, as well as aesthetic reasons (cleanliness and beauty).

Some communities believe that FGM is a religious requirement, although it is not mentioned in major religious texts such as the Koran or the Bible, rather FGM practice is deeply rooted in a strong cultural/social framework. It is endorsed by the practicing community & supported by loving parents who believe that undergoing FGM is in the best interest of their daughter.  

FGM is supported by both men and women, usually without question. Yet the reasons for the practice are often rooted in gender inequality.

In some communities, it is carried out to control women’s and girls’ sexuality. It is sometimes a prerequisite for marriage – and is closely linked to child marriage.

Some societies perform FGM because of myths about female genitalia, for example, that an uncut clitoris will grow to the size of a penis, or that FGM will enhance fertility. Others view the external female genitalia as dirty and ugly.

Whatever the reason behind it, FGM violates the human rights of women and girls and deprives them of the opportunity to make critical, informed decisions about their bodies and lives.

The truth is that Men, Boys, Girls and Women can be empowered as change agents to end FGM in their various communities.

Empowering young girls with adequate information will help to shape their attitudes and influence their future behaviour towards the abandonment of FGM. The empowerment of girls and Women begins with education.

Topics around FGM should be integrated into formal/non-formal education. The inclusion of this topic would make it less of a taboo and young girls can receive accurate information and this would in turn help break the culture of silence around FGM and other harmful traditional practices (HTPs).

Young girls should be trained intensively to make sure they have the necessary information needed to be an End FGM change agent.

When young girls are trained on what they believe and understand the impact of their voices, they can represent their families and communities with pride, courage and ability.

Proof of this can be seen in Ebonyi state when a teenager, Njideka and two other girls, stood their ground on not undergoing FGM because of the information she had received in in School and the Church. Njideka’s stance led to a public declaration of the abandonment of FGM by some communities in the Izzi Clan of Ebonyi State.

As part of the efforts to empower young Girls as #endFGM change agents in Nigeria, The Output 2 of the joint programme result framework is to “Strengthened girls’ and women’s assets and capabilities to exercise their rights”

The UNJP supports capacity building skills for girls–educated or not–based on competencies, and through comprehensive sexual education programs, professional development and programs of “Girl Club’s” 

The aim of the capacity building is to integrate FGM in the life skills of girls with the objective of making them agents of change in their families and their communities.

Currently these capacity building workshop has taken place in most of the UNJP pilot communities. 

Additionally, Men can provide critical leadership through their roles as decision makers, public figures and opinion makers by speaking out against FGM and ensuring that priority attention is given to the issue. Men can be role models for male adolescents and boys. Men have an essential role to play as community leaders in speaking out, standing together, mobilizing communities and taking action to end FGM and other violence against women.

Engaging Men who are community leaders, including religious and cultural leaders, has proved to be a successful strategy in improving the response of communal justice mechanisms to end violence against women and prevent trafficking of women and girls. The participation of positive male role models in campaigns that condemn violence against women has also shown promising results.

Under the UNFPA-UNICEF Joint Programme for elimination of FGM in Nigeria has adopted a strategy known as MALE ENGAGEMENT ALLIANCE IN THE ELIMINATION OF FGM.

This strategy is vital because many interventions on FGM elimination do not engage men or male groups as strategic partners and advocates in leading the campaign to end FGM.  In most cases the men, and male groups, participate in community dialogues and similar social mobilisation interventions but are rarely engaged as advocates due to the belief that FGM is a “woman’s issue”.

This situation has limited the ability of men to contribute to the campaign beyond these initial engagements.  Men in their diverse roles (fathers, husbands, relatives, community leaders, religious leaders, etc.) have been perpetuating the practice of FGM either by omission or commission.

While some men have openly supported the practice by paying for the procedure or served as traditional cutters, others aid the practice through their silence.  Men hold very prominent positions in the community and have a lot of influence within and outside the home, especially in a patriarchal society like Nigeria.

Men also belong to groups (religious, social, traditional, etc.) that address social issues and contribute to the development of their communities.  These Men and their groups have the potential to contribute to the elimination of FGM. 

Unfortunately, the potential of men to use their different platforms and positions to develop their communities, have not been well explored.  Engaging men as endFGM advocates will bridge this gap by engaging community-based male groups as strategic partners in promoting women’s health by advocating for the elimination of FGM.

The expectation is that if men become involved in the campaign to eliminate FGM, there is a greater likelihood that they will motivate their families and community’s to end FGM.

In 2018, the UNJP trained representatives of male groups from selected communities in the intervention LGA (Ekiti, Ebonyi, Osun and Oyo States) and supported them to form a coalition called “Male Engage Alliance to end FGM”. This strategy has been successful.

In conclusion, Collective abandonment, in which an entire community chooses to no longer engage in FGM, is an effective way to end the practice. It ensures that no single girl or family will be disadvantaged by the decision and can be achieved with the collective efforts of Men, Boys, Girls and Women.  

At this point, I will step aside to entertain your questions or comments or contributions. Thank you so much for participating at this conference and we hope you had a great time learning our platform.

For more information, please visit www.endcuttinggirls.org also follow us on Facebook, Twitter and Instagram via @endcuttinggirls. don’t forget subscribe to our YouTube channel via https://www.youtube.com/channel/UCyB8f8IM3k2xTsKNfUZf9wg?sub_confirmation=1 for educational videos on FGM. 

Together, we will end female genital mutilation in this generation.