10 Facts

Why is FGM/C practiced?

Most of the motives fall into one of three justification patterns:

1. Tradition/social norm:

FGM/C is often viewed as a culturally rooted tradition and social norm. In some places, FGM/C is an integral part of a rite of passage from girl- to womanhood intended to prepare girls for their roles as wives and mothers. To follow the tradition is an expression of respect towards previous generations and a sign of gratitude for one's own origins. Breaking the tradition can be seen as an insult to family and ancestors. Reactions to this can be very emotional up to life-threatening.

2. Religion / spiritual and sexual “purity”

Religious commandments and ideals of spiritual and sexual “purity” are often cited as motivation for FGM/C, although none of the major religious scriptures prescribes FGM/C. Nevertheless, representatives of various religions are convinced that FGM/C could create harmony between the will of a spiritual being and a human being. “Medical myths”, i.e. moral or hygienic perceptions of female sexuality and the female genitalia, can also play a role in this context. For example, it is assumed that female sexuality would be unrestrained without FGM/C or that female genitalia would be dirty without FGM/C.

3. Economic reasons

FGM/C is usually considered a prerequisite for a woman to get married and start a family. Without FGM/C, women have worse chances of getting married and the bride price is lower. In many contexts in which FGM/C occurs, the structures are such that single women, and even more single mothers cannot secure their own livelihood and that of their children independently. Further, also a woman's social status is determined by whether she is married and has children. Without FGM/C, women often experience social exclusion and discrimination.

FGM/C has no health benefits for women and girls and cannot be reversed. All forms of this practice can have serious physical, psychological and social effects. FGM/C is one of the leading causes of death in countries where it is practiced. According to a study conducted by the Universities of Birmingham and Exeter in 15 African countries in 2023, over 44,000 women and girls die there due to FGM/C every year.

The acute and chronic consequences of FGM/C fall into three categories. The extent of the consequences depends on various factors, including the type of mutilation (types I-IV), the instruments used, the environment in which the procedure takes place, the previous experience of the FGM/C practitioner and the state of health of the person undergoing the procedure. The most common consequences include:

Illustration: Cora Hein

FGM/C is often associated with myths that can be refuted from a medical or human rights perspective, but may nevertheless have a major impact in case of social acceptance of FGM/C, lack of education and poverty. As FGM/C is a taboo, girls are rarely told in advance what happens during the procedure and what consequences it can have. The myths about FGM/C suggest that the procedure is essential and desirable. In the fight against FGM/C, it is therefore important to counter common myths with facts and thus invalidate them.

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Contact with the (uncut) clitoris leads to impotence in the man or the woman's male offspring.

If this were true, the majority of men in countries where FGM/C is not practised would have to be impotent*. The birth rates in these countries contradict this.

FGM/C increases a woman's fertility.

On the contrary! FGM/C can lead to infertility in women. This is due to infections and inflammation caused by FGM/C, which can, for example, damage the fallopian tubes*.

FGM/C prevents sexual promiscuity and the risk of infidelity by women in relationships.

Implying that women are sexually licentious because of their gender is discriminatory and wrong. The fact is that FGM/C can reduce a woman's sexual sensitivity and desire, which is not desirable*.

Only a woman who has undergone FGM/C is a “real” or fully-fledged woman.

Article 1 of the Universal Declaration of Human Rights states that all human beings are born free and equal in dignity and rights. Dogmas that link the full value of women to criteria, such as a partner, children or FGM/C, should be viewed critically. Because who establishes them and for what purpose?

FGM/C makes women visually/morally more attractive.

Presenting unharmed female genitalia as a flaw in beauty is misogynistic*. Declaring a human rights violation to be moral is inhumane, because it can never be a social consensus**.

An uncut clitoris can grow to the size of a penis and, in the worst cases, hang down to a woman's knees.

The clitoris of an adult woman can be between 7.5 cm and 12.5 cm long and continues to grow over the course of her life. However, 90 per cent of the organ lies inside the body and is not externally visible. Even in a woman’s old age, the externally visible part of the clitoris is significantly smaller than a man's penis, let alone a thigh*.

Contact with the (uncut) clitoris is fatal.

If this was true, there would be far fewer men in the world than there actually are. The fact is that FGM/C can be fatal for women and girls. FGM/C is an extreme health risk!

FGM/C makes the vulva more hygienic and helps women to become “clean” or “pure”.

Unharmed female genitalia are neither “unclean” nor “impure”’*. There is absolutely no scientific basis for declaring components or secretions of the female genitalia to be unhygienic.

Without FGM/C, organs or the foetus can fall out of the vulva.

This is medically refutable. Although women can be affected by one or more pelvic organs (e.g. bladder or uterus) descending into the vagina*, FGM/C does not protect them from this.

FGM/C is a religious obligation.

FGM/C already existed before the emergence of Christianity and Islam. Neither the Bible nor the Koran mentions FGM/C as a religious practice*.

FGM/C is an integral part of the culture of a particular country or continent.

Does “the” culture of a country or continent exist? Countries and continents are culturally diverse*. Besides, culture is not static, but dynamic**.

FGM/C is a prerequisite for marriage and motherhood.

In some contexts, FGM/C (as a supposed guarantee of virginity) is considered a prerequisite for a woman's marriageability. However, tying marriage to such conditions is discriminatory and a violation of rights*. Motherhood is actually made more difficult by FGM/C**

* The fact is that impotence in men has physical causes in 80 per cent of cases, e.g. damage to the blood supply or muscles. Certain diseases, hormonal or psychological disorders can also increase the risk.

* Scientific evidence shows that FGM/C can increase the risk of infertility by a factor of five to six. The more severe the form of mutilation, the higher the risk.

* The clitoris alone, of which the externally visible part is usually amputated during FGM/C, has around 10,000 nerve endings, twice as many as the penis. The risk of pain and infection as well as other injuries during sexual intercourse can be significantly increased for women affected by FGM/C. Some may be denied a fulfilling sex life altogether.

* FGM/C can cause tissue swelling, scarring, infection and inflammation, affecting not only the woman's appearance but especially her health.
** Morals are values and rules that are accepted as binding in a society and should determine behaviour.

* The international average length of an adult man's penis is 9.16 cm when not erect and 13.12 cm when erect.

* They serve the sexual activity, hormone secretion and reproduction of women. Their anatomy is a complex system in which each part has its own extremely important function for the body.

* The cause is pelvic prolapse, which is associated with stretching or damage to the pelvic tissue or pelvic muscles. Risk factors include childbirth, severe obesity and injury during surgery.

* In the Quran there are sayings of the Prophet (Hadith) in dialogue with a cutter, e.g.: “Reduce but do not destroy”, but these are controversially discussed and interpreted. In many Muslim countries, e.g. Libya, Jordan and Turkey, FGM/C is not practiced. In other countries, FGM/C is practiced by followers of all denominations, animists, and non-believers. Religious authorities of all denominations repeatedly speak out publicly against FGM/C.

* Even if a majority of the population, for example in Sierra Leone, were to describe FGM/C as an integral part of their culture, this would not mean that all women and girls would see it the same way or have to undergo FGM/C.
** If there had been no cultural change in Germany, women would not be allowed to vote, study or work today. Practices that violate human rights must and can be changed!

* In many cases, marriage and motherhood are not an option but a must for women in order to survive, i.e. women only achieve security and status through a husband and children. From a human rights perspective, all genders must have equal opportunities. A woman's future must neither depend on marriage and motherhood nor on FGM/C! Conditions regulating access to marriage and motherhood should protect those involved, as is the case, for example, with the minimum age for marriage, the ban on forced marriage or with sex education. FGM/C is a violation of human rights and has no protective effect whatsoever!

Illustration: Cora Hein

Medicalization of FGM/C means that the practice is carried out by healthcare providers such as doctors, midwives, or nurses, often in clinics, at home or elsewhere, using surgical instruments, anesthetics and antiseptics. This includes re-infibulation, which is the re-closure of a woman's external female genitalia, e.g. after childbirth and/or gynecological procedures.

As early as 1979, during the first International Conference on FGM/C, the WHO publicly condemned the medicalization of FGM/C.

Prevalence of medicalized FGM/C

According to UNICEF, around one in four of those affected by FGM/C had the procedure carried out by healthcare providers, around 52 million girls and women worldwide. And the trend is upwards: while 16 per cent of older women between the ages of 45 and 49 were affected by medicalized FGM/C, this already applied to 34 per cent of girls and young women between the ages of 15 and 19, which indicates an increase in medicalized FGM/C.

According to statistics, medicalized FGM/C is particularly widespread in eleven countries: Sudan, Egypt, Indonesia, Guinea, Nigeria, Kenya, Djibouti, Ghana, Chad, Iraq and Yemen. The prevalence is currently highest in Egypt and Sudan, where FGM/C is performed more frequently by healthcare providers than by traditional FGM/C practitioners.

Data source: UNICEF 2020

Background and analysis

To this day, there is no law in Sierra Leone that protects women and girls from FGM/C. The country’s constitution does not recognize FGM/C as a human rights violation, and the provision for protection from inhuman treatment (Article 20.1: “No person shall be subject to any form of torture or any punishment or other treatment which is inhuman or degrading.”) is also not applied to FGM/C.

Sierra Leone has ratified several international agreements whose goals are actually incompatible with the continued legality of FGM/C. Nevertheless, attempts to criminalize FGM/C in national legislation have repeatedly failed or remained limited to temporary bans. Below is an overview of important legislative initiatives, international agreements, and other developments in this regard:

The debate on how to tackle FGM/C in Sierra Leone is dominated by two different approaches: the “Age of Consent” approach and the “Zero Tolerance” approach. The former calls for a ban on FGM/C only for girls under the age of 18 – adult women, on the other hand, should be given the opportunity to decide in favor of the procedure. The “Zero Tolerance” approach instead advocates a complete ban on FGM/C regardless of age.

TW: This video contains accounts of deaths as a result of FGM/C (not explicitly described)

Any Sierra Leonean politicians who express criticism of FGM/C at all usually focus on the “Age of Consent” approach and formulate their concern as a child protection issue, especially since FGM/C is usually equated with marriageability in Sierra Leonean culture and the demand for girls to be of age at the time of the procedure is thus intended to help prevent teenage marriages and pregnancies and to enable girls to attend school for longer. Although the described connection between FGM/C and early marriage undoubtedly exists, this narrative generally fails to shed light on the fundamental dangers and consequences of FGM/C, which affect all women and girls regardless of their age.

The National Sowei Council, as political representation of FGM/C practitioners, has adopted the “Age of Consent” approach as a supposed compromise in the context of the bitter discussions about the general legitimacy of FGM/C, and has at least officially called on its members to only cut young women when they reach the age of majority. However, practice shows that FGM/C on minors still occurs regularly and the vast majority of Soweis do not feel bound by the age regulation.

The “Age of Consent” debate also divides the Sierra Leonean NGO scene, as a number of organizations also advocate this approach. However, the TDF partner organization AIM, together with many other NGOs, clearly supports a “Zero Tolerance” stance. They emphasize that the consequences of FGM/C do not care about age limits and point to the repeatedly occurring deaths also among women of legal age. Furthermore, in view of the taboo surrounding FGM/C that still prevails in large parts of society and the immense social pressure to join the Bondo Society and thus undergo the cutting rituals, a truly self-determined and fully informed decision in favor of FGM/C hardly seems possible.

As FGM/C is still not banned by law in Sierra Leone, potential criminal prosecution is only conceivable if the cutting takes place under physical coercion and explicitly against the will of those affected – a circumstance that can hardly ever be proven given the absolute secrecy of all activities in the Bondo bush – or if complications end fatally. But even in these cases, the road to bringing the guilty parties to justice and achieving an actual conviction is long and bumpy.

This is mainly due to the influential and well-connected Bondo Society, which does not hesitate to use its social and political weight to exert pressure on a large number of actors in order to protect its members. It has already happened that after the arrest of Soweis, police stations were frequented not only by the other local Soweis, but also by their colleagues from other districts and nationwide protests were threatened, whereupon the suspects were released and no further prosecution took place. When damaged parties sue the Bondo Society, the lawsuit is usually dismissed by the courts. Often, the cases are not even brought to trial, as they are repeatedly postponed without valid justification, or relevant files disappear. Some cases are dismissed on the pretext that they could violate the security of the state. The intimidation of plaintiffs and witnesses is also a common strategy of the Bondo Society.

Source: The Guardian

NGOs working against FGM/C, above all the umbrella association “Forum Against Harmful Practices” (FAHP), which is chaired by the TDF partner organization AIM, are fighting against this obstruction. Their aim is to achieve at least one successful conviction and thus set a precedent that will facilitate the future legal prosecution of deaths caused by FGM/C. To this end, the FAHP is currently supporting the ongoing cases of three underage girls who died after FGM/C in December 2023 and of 21-year-old Maseray Sei, who died in December 2021. For the latter, an autopsy report had even confirmed FGM/C as the cause of death, but despite this, the case did not go to court initially. The judge in charge claimed that one word in the medical report was incomprehensible and refused to open the proceedings. With the support of the FAHP, the case was finally referred to a higher court, whose decision is still pending.

Organizations like AIM have broken the silence on the traditionally taboo subject of FGM/C with their pioneering work. Despite ongoing resistance from politicians and society, there are now a large number of civil society groups in Sierra Leone that are openly campaigning against FGM/C. The desire to connect these organizations more closely, create synergies and join forces to fight FGM/C in Sierra Leone ultimately led to the founding of the “Forum Against Harmful Practices” (FAHP) in 2014. This umbrella association now has 26 member organizations, a seven-member board (AIM founder and director Rugiatu Turay is chairwoman) and an office with 11 employees.

The FAHP does fundraising for the projects of its member organizations, extensive research and public relations work on the subject of FGM/C, and campaigns at a political level for a legal ban on the practice and the criminal prosecution of deaths caused by FGM/C. A central position of the FAHP is that all member organizations must commit themselves to the “Zero Tolerance” approach, i.e. to the demand for a complete ban on FGM/C, and not, as advocated by large parts of Sierra Leonean politics and also some NGOs, a ban exclusively referring to minors (“Age of Consent” approach).

Here, FAHP director Aminata Koroma tells more about the history, activities and goals of the forum:

TW: This video contains accounts of deaths as a result of FGM/C (not explicitly described)