Female genital cutting or circumcision (FGC)

Female genital cutting or circumcision (FGC) involves the cutting or altering of the external female genital organs. It is a traditional cultural practice rather than a religious one, and its origins are unknown. The practice is found in some communities and ethnic groups in parts of Africa, the Middle East, Asia and South America.

According to the World Health Organization, around 200 million women worldwide are affected, and around three million girls undergo the procedure every year. Some women who have experienced FGC in their country of birth now live as migrants in other parts of the world.

You may also hear the term female genital mutilation (FGM). It is important to tell your health professional which term you prefer to describe your own situation or experience.

Types of female genital cutting#

The different types of FGC are classified by the extent of the practice involved. They are commonly grouped into four types.

• Type I (clitoridectomy): The hood of skin that sits over the clitoris (prepuce) is removed. The clitoris itself may or may not be removed, in part or in total.
• Type II (excision): The clitoris is removed, and the inner lips (labia minora) are partially or totally removed.
• Type III (infibulation): All or part of the labia minora and labia majora are removed, and a seal is stitched across the vagina, leaving only a small opening for the passage of urine and menstrual blood.
• Type IV (other practices): This includes piercing, cauterising, scraping or using corrosive substances designed to scar and narrow the vagina.

Health impacts#

FGC has no health benefit to women and girls, and it can have negative effects on sexual and reproductive health. There may be immediate and long-term health impacts, including:

• severe pain, bleeding, shock, infection and, in some cases, death
• scarring and cysts
• blocked flow of urine, urinary incontinence and recurring urinary tract infections
• infections of the pelvis
• increased risk of infertility
• painful sexual intercourse and reduced sexual enjoyment
• post-traumatic stress, including nightmares and flashbacks
• depression, chronic anxiety and social isolation
• childbirth difficulties, such as severe tearing and haemorrhage

The law and FGC#

Female genital cutting is illegal in many countries, in all circumstances. Where it is against the law, this can also include taking a person elsewhere for the procedure.

It is also generally against the law to perform re-infibulation after childbirth, which narrows or closes the vaginal opening. Restitching immediately after childbirth by a doctor or midwife is only carried out to repair tearing.

De-infibulation#

The operation to reopen the vagina is called de-infibulation. It is considered a form of corrective surgery and may be performed by a gynaecologist (a specialist in the female reproductive system), a nurse or a midwife. The procedure can be offered to both pregnant and non-pregnant women, in a range of public and private hospitals.

Support services#

A range of support services exists for women, girls and families affected by FGC. These can include:

• healthcare support, education and options for women who have experienced FGC
• community education and information about FGC and reproductive health
• primary and secondary prevention
• culturally sensitive support and services for women and girls who have experienced FGC or are at risk of it, including appropriate referral pathways

Trained workers can use culturally appropriate resources to run health and wellbeing sessions with women and girls from communities where FGC is known to be practised.

Key points#

• FGC is the partial or complete removal or altering of the external female genital organs, done for cultural rather than medical reasons.
• It is grouped into four types, ranging from removal of the clitoral hood to infibulation.
• FGC has no health benefit and can cause serious short- and long-term physical and psychological harm.
• It is illegal in many countries.
• De-infibulation can reopen the vagina, and culturally sensitive support services are available.

Where to get help#