Female Genital Mutilation - An informative guide

This article features content regarding the practice of Female Genital Mutilation (FGM). It is not intended to upset or harm any person, but simply to inform of this practice. I’m flagging this now in order for readers to prepare themselves, either to engage or disengage from reading the piece. Stay safe and look after yourself. According to the HSE, Female genital mutilation (FGM) is defined as the partial or total removal of the external female genitalia, or any practice that purposely changes or injures the female genital organs for non-medical reasons. It can also be known as female circumcision or female  genital cutting. FGM is a cultural tradition typically carried out on someone with a vagina  between birth and the onset of puberty, although many reports show cases being carried out  later on in life as a way to continue the work that was initially performed following certain  changes to the body, such as childbirth. FGM is most commonly practiced in countries in Asia,  the Middle East, and Africa with around 42% of cases occurring in four countries on the African  Continent. The World Health Organisation (WHO) state that between 100 and 140 million  people with vaginas have undergone this procedure, and a total of 3 million people globally are  at risk of this procedure each year. The United Nations has ruled FGM as both a violation of  Human Rights and a violation of the Rights of a Child. FGM is believed to promote purity and modesty among those who have undergone the  procedure, and those who haven’t face dishonour, both from family and from the community,  alongside the belief that because it wasn’t done, they are “unclean”. Not having it performed  means that they may also face exclusion from the community for not conforming and following  tradition. It is believed that the process of FGM “demasculises” the person, making them more  feminine, and therefore more desirable, in the eyes of the society. FGM has no medical  benefits, making it different from the process of circumcision, which has been proven to have  many benefits to the sexual and physical health of someone who undergoes the procedure. In Ireland, performing the procedure of FGM and removing someone from the state in order to  perform FGM is outlawed according to the Criminal Justice (Female Genital Mutilation) Act  2012. According to a report published by the European Institute of Gender Equality (EIGE) in  2015, there were then up to 1,632 people with vaginas under the age of 18 who were at high  risk of FGM. However, since 2011, a total of 3,780 people with vaginas had been affected by FGM  according to HSE reports. These figures may be skewed for many reasons, namely because they  were reported nearly ten years ago, but further reports suggest that FGM and the culture of  FGM still exists and occurs frequently in Ireland. As the nature of these processes are illegal,  this means those undergoing FGM are going into surgery under unregulated circumstances,  possibly making this entire process even more dangerous and harmful.The next section is quite graphic, so please think of yourself before reading it.  FGM can be performed in four main ways, each with their own subsections but the main focus  of that surgical process remains the same. The following definitions were taken directly from  the WHO website, in order to get the most concise and accurate descriptions. The first type of FGM involves the partial or total removal of the clitoral glans (the external and  visible part of the clitoris) and/or the prepuce/clitoral hood. Removal of the clitoris is medically  referred to as a clitoridectomy, and in any circumstance it is considered a form of FGM.  Type two is the partial or total removal of the clitoral glans and the labia minora (the inner folds  of the vulva), with or without removal of the labia majora (the outer folds of skin of the vulva).  Both type one and two are the most common types of FGM received according to a survey by UNICEF in 2013. The third type of FGM has been classified by the United Nations as the “sewn closed” category.  It may also be referred to as infibulation, which is the narrowing of the vaginal opening through  the creation of a covering seal. The seal is formed by cutting and repositioning the labia minora,  or labia majora, sometimes through stitching, with or without removal of the clitoral  prepuce/clitoral hood and glans. A small passage is left open in order for the person to pass  urine or menstrual fluid. Following the sewing, the person’s legs are usually bound together for  as little as two weeks, or as long as six in order to help the tissue around the vaginal area to  fuse and heal. In most cases, the vagina is reopened for intercourse later in life, usually when  the person has married and usually by either a penis or by a midwife. According to a survey on  FGM run by Edna Adan Ismail, a pioneer against FGM in Somalia, families of both partners may  be present in order to check if the person who has been sewn shut is still a virgin. Childbirth  also provides an occasion where a person's wound must be opened, but they are usually cut  further and sewn shut once again afterwards.  Type four of FGM also moves in a different direction to type one and two. It is a broader category and encompasses anything performed unto a vagina for non-medical reasons. Very  often this will include cauterisation, pricking and scarring the genitals, forcefully tightening the  vagina, adding chemicals or other objects to the vagina to change the PH or make it drier,  cutting the front or back of the vaginal cavity in order to make the birthing process easier later  in life, removal of the hymen as a child or the process of Labia Stretching for cultural or  cosmetic reasons. As mentioned earlier, FGM has no health benefits for those it is performed upon. It does, however, lead to a plethora of complications following the procedure and throughout life. The  procedure itself can often lead to the person haemorrhaging from their wounds, infection  spreading to surrounding areas such as the anus or the urethra, with that leading to an increased risk of contracting UTIs. Tetanus, Gangrene and Septicaemia also have high contraction rates from the procedure. As there is often no regulation with how the procedure is  performed, the spread of bloodborne viruses such as Hepatitis B, Hepatitis C, and HIV can severely  impact those receiving the procedure. Consequences later in life may include the formation of  obstructive scar tissue or keloids on the area where the procedure was performed, obstruction of urine or periods leaving the body, leading to either extremely painful periods and/or recto or vesicovaginal holes being formed from the build-up of urine.  Hematometra is also common, and this is when the vaginal cavity and the uterus begin to fill up  with menstrual blood, which in turn will usually aid the formation of diseases like endometriosis. Pelvic Inflammatory Disease (PID) and extreme pain experienced during sex are  also common. During pregnancy and labour, there is a higher risk of neonatal mortality to  children of a parent who experienced FGM, often due to the damage from the procedure. Vaginal laceration, damage to the rectal sphincter and emergency caesarean sections are often  required in order to save the child. All of these side effects have acute impacts to someone who  has experienced FGM, and this curse does indeed follow them throughout their lifetime. If any part of this piece has upset you, please reach out to some of the following resources: Samaritans Cork: 116 123 Student Counselling and Development UCC: counselling@ucc.ie If you would like to know more about FGM, you can find out more from the following sources: World Health Organisation: The WHO have many resouces on FGM and are running a collaborative campaign with UNESCO, UNICEF, UNIFEM and many others on eliminating  FGM in today’s world Akida.ie: A network of migrant women living in Ireland who do so much work  alongside their commitment to informing people about FGM in Ireland and globally. HSE: The HSE offer resources about FGM on their website, alongside a free FGM treatment service in Dublin for those of any age who have experienced FGM in their lifetime. Glow West Podcast: In episode 30 of Dr Caroline West’s podcast she talks to Dr Caroline  Munyi from Akida.ie about FGM and a more in depth look into what Akida.ie do in Ireland. Edna Adan Hospital: The Edna Adan Hospital is a nonprofit set up by Edna Adan (mentioned  earlier) in order to combat FGM and other medical issues faced by women and children in both  Somaliland and across Africa. They have many resources regarding FGM on their website.