Three new papers on FGM worth reading

  1. Re-thinking the Zero Tolerance Approach to FGM/C: the debate around female genital cosmetic surgery, by Janice Boddy, Current Sexual Health Reports, 21 November 2020 

The main point of this paper is that there is a growing phenomenon of young women having “cosmetic labiaplasty” in Europe, the Americas, and Antipodes, carried out by medically trained gynaecologists and plastic surgeons, which is based on the aesthetic belief that if the labia minora protrude beyond the labia majora this is deemed ugly, masculine, and ‘abnormal’, and they should be “trimmed”. The kind of surgery involved is the same as what the World Health Organization calls female genital mutilation type II. The fact that for the mainly white, western women having this form of surgery it is called cosmetic surgery and is legal, while for African women who have it, it is called genital mutilation and is criminalised, is the focus of this paper. The author, who is a Canadian anthropologist, also identifies the fact that in all the cultures where these very similar phenomena are happening, it is strong beliefs about what is aesthetically acceptable that influence the practice.

2. New advisor missed opportunity to celebrate FGM decline in UK, by Brid Hehir, Shifting Sands, 13 October 2020.

The main point of this paper is this: A small but important piece of original research in the British Medical Journal, which should have received more publicity, was published just a week before the International Day of the Girl Child this year. The research confirms that few young children (103 cases) are presenting with FGM in Britain (or Ireland) and none were found in Northern Ireland. Moreover, most of the cases still being reported are historic – 70% were carried out prior to the children arriving in Britain — indicative of changes in practice in communities that used to believe in FGM, which has been recognised in those communities in the UK for quite a few years now, though not acknowledged by everyone who is a UK activist opposing FGM. 

3. How to ensure policies and interventions rely on strong supporting facts to improve women’s health: the case of female genital cutting, using Rosling’s Factfulness approach, by Birgitta Essen, Luce Mosselmans. Acta Obstet Gynecol Scand. 2020 Dec 11. 

This paper applies Rosling et al’s framework from the book Factfulness, which aims to inspire people to use strong supporting facts in their analyses of issues and to fight dramatic instincts. The abstract says: In this paper, the Factfulness framework is applied to female genital cutting (FGC), in order to identify possible biases and promote evidence-based thinking in studies on FGC, clinical guidelines on management of FGC, and interventions aimed at abolishing FGC. The Factfulness framework helps to acknowledge that FGC is not a uniform practice and helps address that variability. This framework also highlights the importance of multidisciplinarity to understand causalities of the FGC issue, which the authors argue is essential. This paper highlights the fact that FGC is a dynamic practice, with changes in the practice that are ongoing, and that those changes are different in different contexts. The “zero tolerance” discourses on FGC fails to acknowledge this… 

These papers all raise issues that a range of authors from several world regions have been writing about for the past 15-20 years. I was able to share that work and give a lot of attention to it as the editor of Reproductive Health Matters. These papers can be found on the first 2 pages of articles listed at this link (keyword FGM) and this link (keyword cosmetic surgery), though some items in these lists are on other issues. The papers cover not just genitals but also breasts and the meanings of altering the body to achieve beauty. Definitions of what is considered beautiful in girls and women in every culture create a lot of pressure to conform. See especially one article called Make me beautiful, by Omid Salehi, interviewed by Negar Esfandiary. Some practices carry health risks and the risk of complications. To me, part of the challenge of feminism for girls and women is that we should not feel we have to risk our health or even our lives to achieve what others want us to believe constitutes beauty, let alone what is defined as essential for being female. It seems we must keep coming back to these same issues with each generation as the forces that create this pressure often come from those who hope to gain something themselves.

Marge Berer, 6 December, revised 13 December 2020