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Tackling a tough topic: Ahoua Kone discusses FGC/M

Posted: Jun 03, 2014 · Posted by: Lisa Niemann

Female genital cutting (FGC), also called female genital mutilation (FGM) or female circumcision (FC), is a topic that is divisive enough that even what to call it the practice contentious.  Ahoua Koné, Director of Côte d’Ivoire Projects at HAI, recently gave a talk to UW students to help wade through the issue and explore the topic, which has been practiced throughout much of Africa, including Côte d’Ivoire, her native country.

According to World Health Organization, FGC/M is “a procedure intentionally performed to partially or completely alter the external female genitalia with no known medical benefit,” though some argue that the term “mutilation” has a negative connotation and places a value judgment on the practice. They believe the practice is a part of their cultural, historical, and/or religious practices, and thus the term “mutilation” can be offensive. Others argue that FGC/M is a harmful practice that must be stopped and that any negative judgment the term “mutilation” implies is appropriate.

Some struggle to compare FGC/M to the more globally accepted practice of male circumcision. Or is it more like the practice of foot binding, practiced in China for centuries and then eliminated within a generation? Could one compare it to western cosmetic practices, such as breast augmentation surgeries, or the painful high heel trends that women subject themselves to? These comparisons all provide interesting points of similarity, yet none capture all the complexities of FGC/M itself.

Perhaps, then, it is important that we define FGC/M and understand the context of those who both oppose and support the practice, which is exactly Ahoua’s presentation first focused on.  There are several types of FGC/M, ranging from a symbolic act or ceremony (generally known as type 0) to a complete removal of the clitoris and inner and outer labia (type IV or Infibulation).

For most people who have not grown up with this practice as a part of their culture, this practice, regardless of the type, is seen as a human rights violation and as gender-based violence or discrimination to control female sexuality.  This argument is supported by the negative short- and long- term physical and emotional consequences that girls and women experience as a result of FGC/M. As a response to these views, and largely due to pressure from Western advocates, policies and laws have made the practice criminal in some countries.  While criminalization of FGC/M has brought some positive results in some places, in other places it had pushed the practice underground and created additional risks to children and their families, including conducting the practice in the home and at younger ages to avoid legal repercussions.

Ahoua says that in her culture, the practice was seen as a rite of passage and portrayed in positive ways such as increased marriageability, cleanliness, and deep bonding experience with other women.  While over time many families are realizing that the negative health outcomes of FGC/M outweigh the advantages, the cultural traditions are not easily changed. In some communities, there is still resistance to ending the practice. Recent surveys have shown that rates of FGC/M have gone down in many places, some countries more rapidly than in others.  In Ahoua’s culture, and in many others, it is often women who tend to defend the tradition and ensure it is passed down to their daughters. 

Caption: Declines in FGC/M as reported by selected countries’ Demographic and Health Surveys (source)

If the practice is to be stopped, it seems that pressure and outcry from the rest of the world is not the whole answer. Motivation also needs to come from women who themselves practice FGC/M.  The global community can help create ‘right conditions’ for such changes to occur, such as encouraging training of health providers to address issues related to FGC/M with families and support education and empowerment of young girls, women, and their communities so that they are in positions to make decisions that protect rather than endanger their daughters and sons.  Finally, the global community must ensure the health of women and their access to quality health care.  

According to the WHO, “more than 18% of all FGM is performed by health care providers, and the trend towards medicalization is increasing,” indicating that health care professionals may have a role to play in FGC/M itself. Furthermore, women who have had an FGC/M procedure done will certainly access medical care in their life. Providers must be competent in providing services to these women.

Ahoua’s talk ended with perhaps more questions than answers, which reflects the vast social, cultural, and political implications of FGC/M.  

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