Female Genital Mutilation-What 140 Million Women Have Endured and Why by Nina Bingham

History: Cultures who practice female genital mutilation prefer to call it female "circumcision." The question that springs to a Westerner's mind is: why would females need to be circumcised when their genitalia has no foreskin? "Despite the issuing by the Ministry of Health in 1959 of regulations which made the practice illegal, recent studies reveal it is still practiced in more than 67% of practicing rural communities and 42% of urban countries" (Salem, 1979; El-DeFrawi, Lofty, Megahed, & Sakr, 1996). Circumcision is a frequent, common practice in Egypt and Africa. In some towns circumcision rates reach up to 95%. In the country of Somalia, 40% of women reported sexual and medical complications due to female circumcision (Dirie & Lindmark, 1992). The World Health Organization (2008, 2010) reports that female genital mutilation (FGM) is practiced in 28 countries, and 140 MILLION girls and women have undergone the procedure.

The Procedure: FGM is carried out on infants to girls from a few days old to puberty, and occasionally on adult women. It is usually performed without anesthesia, with common knives, razors, or scissors (World Health Organization, 2010). "Most of the circumcised women (76%) underwent the procedure between the ages of 8-12 years old. In more than 58%, the circumcision was performed at home, and 50.5% experienced injury to the clitoris. More than half of the circumcised women (53.5%) recalled complications following the procedure. Significantly more of the circumcised women reported lack of sexual desire (83%) and being less orgasmic. Pain during intercourse was reported in significant numbers among circumcised women. Results showed that 80% who were circumcised complained more significantly that the uncircumcised women" (El-DeFrawi, Lofty, Dandash, Refaat, Eyada, 2001). Karim (1993) warned that circumcision may also lead to vaginal muscular spasms, insensitivity, and sexual phobia or fear of sex. Urologist Fourcroy (1998, 1999) writes that women in countries that practice FGM refer to it as "The three feminine sorrows": the first is the procedure itself, followed by the wedding night when a woman has to be cut open, then childbirth when she has to be cut again." One has to wonder how women who have been victims of this practice feel about it?

Old Customs Die Hard: One would assume that a circumcised woman who has reported it to be a harmful procedure would denounce the mutilation. Yet an astonishing 61.5% report having circumcised their daughters or intend to do so (El-DeFrawi, Lofty, Dandash, Refaat, Eyada, 2001). This leads to the question: Why would women who have been the victims of mutilation perpetuate the practice? In sociological terms, this culture-bound behavior is defined as, "Groupthink" (Aronson, Wilson, Akert, (2010): "A kind of thinking in which maintaining group cohesiveness and solidarity is more important than considering the facts in a realistic manner." It could be also be interpreted as "Normative Conformity" (Aronson, Wilson, Akert, (2010): "The tendency to go along with the group in order to fulfill the group's expectations and gain acceptance." To the Westerner's mind, this practice seems barbaric, dangerous, and an attack on female sexuality. One might even consider it hostile aggression against women: aggression aimed at inflicting pain. There are ancient, religious causes as to why women's sexual desire is literally "cut off" in these cultures. The World Health Organization (2012) explains: "FGM is often motivated by beliefs about what is considered proper sexual behavior, linking procedures to premarital virginity and marital fidelity. FGM is in many communities believed to reduce a woman's libido and therefore believed to help her resist "illicit" sexual acts. When a vaginal opening is covered or narrowed (type 3), the fear of the pain of opening it, and the fear that this will be found out, is expected to further discourage "illicit" sexual intercourse among women with this type of FGM. FGM is associated with cultural ideals of femininity and modesty, which include the notion that girls are “clean” and "beautiful" after removal of body parts that are considered "male" or "unclean". Though no religious scripts prescribe the practice, practitioners often believe the practice has religious support."  

A Counselor's Response: As a counselor in a clinical situation who works with culturally diverse families and individuals, should a client share that she has had a clitoridectomy, and further disclose that she lacks sexual desire or experiences sexual pain and psychological issues because of it, how would I proceed with this client?--I would ask what she knows about the impact of this practice on female sexual response.
I would educate her on the research findings of the impact of FGM. I would ask her to share what she experiences sexually and anatomically (or wants to experience sexually, and cannot). I would recommend that she seek the evaluation of a physician or reconstructive surgeon about how to anatomically correct the mutilation. I would let her know that due to the trauma and pain which this procedure causes, she may want to consider discussing the psychological and emotional trauma of it with me. I would reassure her that 140 MILLION women suffer from the effects of mutilation, that she is not alone.  

A Counselor's Editorial: In countries where birth control is not made available to women, FGM is seen as a way of discouraging women from premarital sex, and thus justifies the ritual. Mass-mutilation is occuring because governments do not make birth control available to women, and further do not educate their citizens about birth control. Though FGM is illegal, in some regions, up to 95% of women have fallen victim to it. It seems these governments turn their heads and look the other way while their women are subject to female emasculation and butchery. One has to wonder why the male penis isn't also mutilated in these countries? After all, doesn't it take "two to tango?"

Fear of Femininity: A leading male clinician in the field of academic career counseling recently termed this kind of male behavior towards women, "Fear of femininity." After pointing out the severe injustices still occurring in the workplace towards women in the U.S., Zunker (2012) stated, "Fear of femininity, for instance, may influence men to overcompensate by exaggerated aggressive behavior. A woman who has been sexually harassed in the workplace is an expression of these tendencies." Researchers Eagly, Karau, & Makhijani (1995) state, "Very often, bias against women is most prevalent when their competence is evaluated in traditional masculine roles." Traditionally, sexuality is seen culturally as a male characteristic. To Therefore, paternalistic-cultures apply violent surgery to female children before they have the chance to grow into women with sexual feelings. However, a man's genitals and sexuality are protected, and idealized as virile for these same sexual drives. The double-standard is clear, painfully clear.

References: Salem, A. A. (1979). The practice of circumcision in Egypt. WHO/Emro Technical publication 2, 108–109.

El-Defrawi, M. H., Lotfi, G., Megahed, H. E., & Sakr, A. A. (1996). Female circumcision in Ismailia: A descriptive study. Egyptian Journal of Psychiatry, 19, 137– 145.

Dirie, M. A., & Lindmark, G. (1992). The risk of medical complications after female circumcision. East African Medical Journal, 69, 479–482. World Health Organization. (2008). Eliminating female genital mutilation. P. 4, 22-28. Retrieved from: http://whqlibdoc.who.int/publications/2008/9789241596442_eng.pdf

World Health Organization. (2010). Female genital mutilation. Retrieved from: http://www.who.int/mediacentre/factsheets/fs241/en/

El-DeFrawi, M.H., Lofty, G., Dandash, K.G., Refaat, A.H., Eyada, M. (2001). Female genital mutilation and its psychological impact. Journal of Sex & Marital Therapy, 27: 465-473,

Brunner-Routledge. Karim, M. (1993). Circumcisions and mutilations: Male and female. The Egyptian National Council of Population, Cairo.

Fourcroy, J.L. (1998). The three feminine sorrows." Hospital Practice, 33 (7): 15-6, 21.

Fourcroy, J.L. (1999). Female circumcision. American Family Physician, Aug. 1999.

Aronson, E., Wilson, T.D., Akert, R.M. (2010). Social Psychology. Seventh Edition. Prentice Hall.