Ending 'Female Circumcision' in Practice and Name

Of the different terms used in the West, at least "female circumcision" should be abandoned. At best, it is inaccurate. At worst, it inches the practice into the realm of the medicalized or sanitary, obscuring aspects that still undermine girls' and women's human rights.
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An estimated 125 million girls and women--primarily in Africa--have had their genitalia cut, scraped, or sewn up. In their communities, this is done to preserve their marriageability by preventing anticipated promiscuity and social ostracization. The lifelong cost of non-conformity can be high; even parents who question the practice feel pressured to subject their daughters to the rite.

Recent release of UNICEF's fascinating report about the practice it refers to as "female genital mutilation or cutting (FGM/C)" triggered lively coverage in national and international news outlets. News media have explored the study's findings of an unexpected decline in incidence in parts of Africa, new trends towards medicalization of the practice, and nuanced shifts in social perception.

While the UNICEF report sparked critical discussion about the practice itself, the issue of terminology and its implications must not be overlooked.

The trouble with terms

Across recent articles discussing the practice, terminology is curiously mixed: within the NY Times itself, one article uses the term "female genital mutilation or cutting" (FGM/C) though still referring to "circumcisers," while another refers to "female circumcision." The Economist uses "female genital mutilation" or "FGM," but the BBC uses "FGM" in one article, and "female circumcision" in a more recent podcast.

Debate over vocabulary has persisted in the West for decades. It is not merely academic. Commentators, practitioners, and activists have wrestled with and about the words "mutilation" (potentially stigmatizing), "cutting" (sometimes inaccurate), and "circumcision" (falsely analogous).

In truth, there is no perfect term in Western languages. This is partly because the practice and its meanings vary dramatically across the communities where it exists, and partly because its myriad local names do not lend themselves to easy translation.

Of the different terms used in the West, at least "female circumcision" should be abandoned. At best, it is inaccurate. At worst, it inches the practice into the realm of the medicalized or sanitary, obscuring aspects that still undermine girls' and women's human rights.

"Female Circumcision": A false analogy

First, circumcision has been conducted for thousands of years in males, mainly for religious or supposedly hygienic reasons. It involves removal of the hood of the non-erectile foreskin over the head of the penis, which has little or no negative impact on the sexuality or future health of the male.

Male circumcision is in no way related to the motivation, acts, or health impacts associated with traditional alterations of the female genitalia as practiced across Africa. The procedure performed on young women and girls generally consists of ablation of parts or all of the inner labia and all or most of the clitoris, i.e. of a woman's most sensitive erectile tissue. This can cause a woman numerous physical and psychological consequences over her lifetime, including loss of genital sensation, scar tissue build-up, and adverse obstetric outcomes.

Use of the term "circumcision" for both genders sends the message that the

traditional rite imposed on women and girls is no more traumatic or consequential than what males experience without protest. This is not true. We should clarify once and for all that excision of the clitoris is the equivalent of removing the head of the penis.

"Female Circumcision" and medicalization

Second, the term "female circumcision" can be construed to support a trend noted in the UNICEF data and the BBC podcast: increased medicalization of traditional rites that obliterate female genital sensation. In Egypt, for example, more and more healthcare providers are performing the act with sterile razors, under hygienic conditions. This makes the practice seem like a "normal" surgical intervention akin to male circumcision - an attractive alternative to traditional procedures carried out on young girls with rough tools in often unsanitary settings.

However, this veneer of respectability or regulation obscures the fundamental question of whether extinguishing a woman's natural sexual response constitutes a human rights violation that must be stopped. It also raises serious ethical issues for healthcare providers. This dilemma was directly addressed by a landmarkWorld Medical Association Statement in 1993, which condemns the participation of physicians in procedures affecting the female genitalia that have no medical benefit.

Any medicalization of procedures aimed at deadening a woman's capacity for sexual stimulation only gives these acts a presumed respectability they do not deserve, potentially legitimizing practices which both the WHO and UNICEF have found to violate girls' and women's human rights. Medicalization is a harmful illusion and should be abandoned, not encouraged.

Of all the imperfect Western terms to describe this complex tradition, "female circumcision" should be discarded. It is medically inaccurate, falsely reassuring, and distracts from the fundamental question of whether alteration of the female genitalia for no medical benefit--and, indeed, to limit a woman's full sexual integrity--is a human rights violation.

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Biographical information:

Kim Thuy Seelinger, JD, directs the Sexual Violence Program at the Human Rights Center, University of California, Berkeley School of Law. She has also represented dozens of asylum seekers who have undergone or fled "female genital mutilation / cutting."

Hernan Reyes, MD, is an obstetrician and gynecologist who spent 28 years as medical coordinator for the International Committee of the Red Cross, specializing in prison health and medical ethics. He is currently a Senior Research Fellow at the Human Rights Center and member of the World Medical Association.

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