Female genital mutilation

Female genital mutilation (FGM) is cutting off part or all of the female genitals that are outside of the body. FGM is also called female genital cutting and female circumcision. It is done for traditional reasons, as part of a ritual, not for medical reasons.
FGM is most common in 27 African countries, as well as Yemen and Iraqi Kurdistan. However, it also happens in other countries in Asia, the Middle East and around the world. Usually, FGM is not done by a doctor or in a hospital. It is often done with a razor blade or other sharp instruments, in many cases without anesthesia.
Different ethnic groups do different kinds of FGM. They also do FGM at different ages. Some groups do FGM when infants are only a few days old. Others do it when girls reach puberty, or are older. In about half the countries where FGM happens, most girls have FGM before they are five years old.
FGM can cause serious health problems, like infections, chronic pain, trouble getting pregnant and giving birth, bleeding so bad that it can kill. FGM does not make a person's health better in any way.
FGM is illegal in most of the countries where it happens. However, these laws are often ignored. Since the 1970s, many countries have tried to stop FGM. In 2012, the United Nations General Assembly said that FGM is a human rights problem, and voted to try harder to stop it. The World Health Organization and the "Maputo Protocol" to the African Charter on Human and Peoples' Rights also say that FGM must be stopped.
Types of female genital mutilation.
There are many different types of female genital mutilation. The World Health Organization (WHO) has created four basic categories of FGM, called Types 1-IV.
Type I.
In Type I FGM, part or all of the clitoris is cut off. The clitoris is the female organ that makes sex feel good for women. Without it, a woman usually cannot have an orgasm.
Type II.
There are a few forms of Type II FGM. All of them involve cutting off part or all of the inner labia, the two flaps of skin on the sides of the opening to the vagina. The forms of Type II FGM are:
Type III.
Type III FGM is usually called infibulation. It is the most severe form of FGM. The genitals outside a woman's body are cut off and the wound is sewn shut with thread and thorns. The different types of infibulation are:
When the labia are sewn shut, one small hole is left open so the girl can urinate and menstruate. The hole is kept open by putting something like a twig into the wound. To help the wound close, the girl's legs are tied together, often from hip to ankle, for up to six weeks.
After the woman gets married, her vagina is cut open so she can have sex. A midwife might cut open the vagina with a knife, or the woman's husband might tear it open with his penis. If the woman gets pregnant, the vagina is opened more for childbirth, and then often sewn back up afterward (this is called re-infibulation).
Type IV.
Type IV FGM is anything else that is done to hurt the genitals, like scraping, burning, scarring, or cutting the genitals without cutting them off. This procedure will be heartbreaking for women, when they get to know about this in later life.
Prevalence.
In many countries where FGM is common, almost every woman and girl in the country has had FGM. In other countries, millions of women and girls have had FGM over many years.
In 25 countries in Africa and the Middle East, over 125 million women and girls have had FGM. This includes:
In some of these same 25 countries, FGM is very common. It is most common in these countries:
However, in other countries, FGM is not as common. For example, of the 25 countries where FGM happens most often, it is least common in these countries:
Complications.
FGM can hurt women's physical and mental health throughout their lives.
The type of complications that a girl or woman might have from FGM depend on many things, like:
Short-term complications.
"Short-term complications" are health problems caused by FGM soon after the FGM happened. Common short-term complications include:
More serious short-term complications can cause symptoms that can kill a woman. They include:
Nobody knows how many girls and women die from FGM.
Late complications.
Late complications happen later on after FGM is done. For example:
Painful periods are common because it is very difficult for the monthly menstrual blood to get out of the tiny hole left by infibulation. Blood can fill the vagina and uterus, and stay there without moving. If the vagina gets completely blocked, the vagina and uterus can fill up completely with menstrual blood. Because women with this problem do not menstruate, and blood builds up in their abdomen (making it swell), it can be confused with pregnancy.
Pregnancy and childbirth.
FGM may increase a woman's risk of having problems during pregnancy and childbirth. For example, women who had infibulations are more likely to:
FGM also raises the risk that a woman's baby will die soon after it is born. In 2008, the WHO estimated that 10–20 babies out of every 1,000 die because their mothers had FGM. All types of FGM were found to raise babies' risk of death, which was:
Effects on mental health &amp; sexual function.
There is not much information about the effects of FGM on women's and girls' mental health. However, a few small studies have found that women with FGM often have anxiety, depression, and post-traumatic stress disorder (PTSD).
Studies on how FGM affects women's ability to have sex have also been small. In total, in 2013, there had been 15 studies involving 12,671 women from seven countries. When all the information from these studies was put together, researchers found that: