Female
Circumcision
by Andrea Nichols
Senior Seminar
Paper
Department of
Sociology
Southern Illinois
University at Edwardsville
http://www.siue.edu/~jfarley/nicho490.htm
There are an estimated ninety to a hundred million women and
girls living today in African countries that have had some form
of female circumcision (Lane and Rubinstein 1996). Recent
articles in the media have reported the growing practice of
female circumcision in the US and Europe, among immigrants from
countries where it is part of the culture. Circumcision occurs
for a number of cultural reasons, such as religion, tradition,
preserving virginity, and cultural identification. However, the
practice of severe forms of female circumcision is now proven to
be a great health risk, and the women of the societies that
still practice female circumcision risk severe health problems.
This paper reviews the practice of female circumcision and
proposes a plan to reduce the use of harmful forms of
circumcision, and consequently, the helth problems associated
with it.
The Issues
There are different forms of female circumcision. A form of
female circumcision called excision involves the removal of all
or part of the clitoris, and in some cases other external
genitalia. In the most extreme form of circumcision, called
infibulation, the clitoris and both labia are removed and the
two sides of the vulva are sewn together- except for a small
opening for urine and menstrual blood to go through (Heise
1993). Another, less severe form of circumcision involves small
incisions in the skin covering the clitoris. Eighty- five
percent of worldwide female circumcision involves this less
severe form or excision, and fifteen percent includes
infibulation. Infibulation and excision cause both immediate and
long term health risks. The immediate consequential health risks
of infibulation or excision are shock, hemorrhaging, infection,
pain, urinary retention, and damage to the urethra (Heise 1993).
In a study performed in Cairo, Egypt, 79.3 percent of genital
surgeries happened at home. Only 0.3 percent of the operations
were done in hospitals. Most operations are done without
anesthesia or sterile instruments which often causes Septicemia,
tetanus, or urinary tract infections. Unhygienic salves used to
heal the wound also cause infection. Reproductive health risks
include a loss of sexual sensation, chronic urinary tract
infections, and painful intercourse (Heise 1993). The resulting
scar tissue of infibulation also obstructs birth, and the
consequential tears and hemorrhaging are "likely contributors to
the very high rates of maternal mortality in Sudan and Somalia"
(Lane and Rubinstein 1996). Pelvic inflammatory disease caused
by chronic infection and/ or scar tissue blocking the fallopian
tubes causes sterility, which has extremely high rates in areas
that practice infibulation.
Women and girls are not informed of these health risks. In a
study performed in Egypt, survey data shows ninety- nine percent
of the respondants were not informed of the severe health risks
(Gallo 1996). Another study in Nigeria, with survey data from
over 400 women, also indicates a need for educational reform.
Only 30 percent realized there was a risk of infection, 17
percent realized the risks of birth complications, and 5 percent
realized the risk of extreme blood loss (Ebong 1997).
Religion is also correlated with female circumcision. A large
percentage of circumcised women are of the Islamic faith,
although circumcision is not mentioned in the Islamic holy book,
the Koran. Circumcision is seen as a sign of purity and a way of
retaining virginity by protecting women's sexuality (Lane and
Rubinstein 1996). Also, as these cultures modernize and girls
are sent away to school or work, infibulation is seen as a way
to control sexuality. A large proportion of circumcised women
are from rural areas, where uncircumcised women are not socially
accepted. Respectable men would never marry an uncircumcised
woman, as she would be seen as impure.
Immigration of cultures that practice female circumcision to
cultures that do not practice female circumcision has also
raised questions in countries such as France, Italy,
Netherlands, the United Kingdom, Canada and the US. France
banned the practice when an immigrant father performed the
operation on his infant daughter resulting in her death. Canada
established a policy prohibiting doctors from performing female
circumcisions in Ontario, and the Netherlands Ministry of Health
published a report allowing for only one kind of non mutilating
form of circumcision (Kool 1994). In the United States,
Representative Patricia Schroder introduced a bill in 1996
proposing abolishion of female circumcision in the US. (Lane and
Rubinstein 1996).
There have been policies banning the practice in Kenya,
Egypt, and parts of Europe. The United Nations has also become
involved in attempting to ban the practice. Social, religious,
and traditional reasons for female circumcision have been
questioned as the health risks of infibulation and excision are
more widely understood.
Explaining Female Circumcision
Symbolic interactionism argues that individuals and societies
develop the meanings attached to symbols through social
interactions. Individual's interactions involve an exchange of
information from individuals to other individuals. This pattern
of informational exchange continues, involving a whole society.
One person may exchange information with two people, and
those two people may exchange information with two other people,
continuing the exchange of information to include many people.
Meanings attached to symbols are passed on this way and learned.
In regards to female circumcision, symbolic interactionalism
would argue that girls learn meanings attached to symbols
through interactions with other women and girls. As individuals
learn meanings attached to symbols through interactions with
society, they may develop a sense of themselves based on the
social standards that are set for them. If women are
circumcised, they may see themselves as pure and beautiful
because these are the meanings associated with circumcision that
were learned through interactions with others. Symbolic
interactionism states that an individual's behavior in society
is based on her perception of symbols and the meanings
associated with those symbols. In the course of interactions
with other girls, the positive meanings associated with
circumcisions are learned. The positive meanings associated with
circumcision may include womanhood, purity, fertility, and
beauty.
The idea of the Looking Glass self argues that individuals
develop a sense of themselves as they believe others see them.
When a young girl is about to be circumcised, her mother or
other women and girls in her society will tell her that she is
becoming a woman, that this will help her stay pure, and she
will be beautiful. Everyone in that society will see her as
these positive symbols. The young girl will then see herself as
all these symbols when she is circumcised.
Research supporting the explanation
"When girls of my age were looking after the lambs, they
would talk among themselves about their circumcision
experiences. Every time the other girls talked about their
infibulated genitals, I would feel ashamed I was not yet
circumcised. Whenever I touched infibulated girls, they would
tell me not to touch them since I was [still] "unclean."... One
day I could not stand it anymore. I took a razor blade and went
to an isolated place. I tied my clitoris with a thread, and
while pulling at the thread with one hand I tried to cut part of
my clitoris. When I felt the pain and saw the blood coming from
the cut I stopped .... I was seven years old." (Abusharaf 1998).
The above account describes an overwhelming urge to conform
to socially constructed symbols. Social labels in countries
where circumcision is practiced are strong enough to cause a
seven- year old to mutilate herself. Where it is practiced,
female circumcision is strongly promoted and closely
safeguarded; it is regarded as an essential coming-of-age ritual
that symbolizes virginity, cleanliness, fertility, and enhances
the beauty of a woman's body. These are all symbols girls are
taught to associate with circumcision at a very young age (Asali
1995).
Rite of passage
Through interviews of various African women, female circumcision
is shown to be symbolic as a rite of passage to womanhood. Girls
are showered with gifts and attention after being circumcised.
In some societies the experience includes secret ceremonies and
instruction in cooking, crafts, child- care, and the use of
herbs. After circumcision, adolescent girls are also allowed to
be married. By complying, they also please their parents, who
can arrange a marriage and gain a high bridal price for a
circumcised daughter. Among the Masai of Kenya and Tanzania,
girls are circumcised publicly. Then the cutting becomes a test
of bravery and a proof that they will be able to endure the pain
of childbirth. Circumcision gives girls status in their
communities, because they are seen as women after being
circumcised instead of as girls (Abusharaf 1998). These examples
reinforce the positive meanings associated with circumcision-
purity, fertilty, and womanhood.
Uncircumcised women
Mothers who have their daughters circumcised believe they are
doing the right thing-because their children would become social
outcasts if they did not get circumcised. The consequences of
not undergoing the ritual are extreme. Negative meanings
attached to symbols are also learned through social
interactions. An uncircumcised woman is labeled unclean, impure,
and unfit to marry, bear children, or attain respect in old age.
Interviews of the Sabiny people of Uganda state that an
uncircumcised woman who marries into the community is always
lowest in the pecking order of village women, and she is not
allowed to perform the public duties of a wife, such as serving
elders. Uncut women are called girls, no matter what their age
is, and are forbidden to speak at community gatherings. The
social pressures are so intense that uncircumcised wives often
become circumcised as adults (Abusharaf 1998).
Woman's virginity
Another less common reason given for infibulation or excision is
decreasing a woman's sexual desire in order to preserve
virginity. Infibulation is intended to dull women's sexual
enjoyment, and it appears to be extremely effective. In a survey
conducted in Sierra Leone, circumcised women reported feeling
little or no sexual responsiveness. The clitoris is always at
least partially removed during the operation, and without it
orgasm becomes practically impossible. Uncircumcised women are
generally assumed to be promiscuous, and man-chasers (Abusharaf
1998). Purity and virginity are closely associated with
circumcision. Symbolic interactionism would argue that this
concept is learned through interactions of individuals within a
society.
Tradition and Folklore
Female circumcision is deeply enmeshed in local traditions and
beliefs. Interviews of 21 Bedouin women in southern Israel
uncovered several reasons for circumcision. The most common is
social pressure to maintain tradition. The second most common is
the belief that uncircumcised women are not good bakers or
cooks. Many women believe that after circumcision, women are
cleaner. The justifications for female circumcision vary.
Interviews of ethnic groups in Nigeria believe that if a woman's
clitoris is not removed, contact with it will kill a baby during
childbirth. Other people believe that without circumcision, the
female genitalia will continue to grow. Vaginal secretions,
produced by glands that are often removed as part of the
surgery, are thought to be unclean and lethal to sperm. These
examples of folklore show socially constructed negative symbols
towards uncircumcised women. These social symbols are learned
through interactions with other women and girls.
The Male Role
Men are emphatically not involved in female circumcision,
according to all informants (Asali 1995). Fathers are not aware
of whether daughters have had circumcision. Women, not men, are
the custodians of the ritual- in fact, a Sudanese man recently
made headlines by filing a criminal lawsuit against his wife for
having their two daughters circumcised while he was out of the
country. Why do women subject their daughters to what they know
firsthand to be a wrenchingly painful ordeal? Many are simply
being practical. "I think that it is very important for the
virginity of women to be protected if they want to get husbands
who respect them," a fifty-five-year-old Sudanese mother of five
girls reports (Abusharaf 1998). Getting married and having
children is a survival strategy in a society plagued by poverty,
disease and illiteracy. Conflict theorists would argue that the
socioeconomic dependence of women on men affects their attitude
toward circumcision. Women are more likely to get married to
wealthier men if they are circumcised. Symbolic interactionism
would argue that socially learned meanings associated with
circumcision-purity, fertility, beauty, and womanhood- are
appealing to men.Uncircumcised women are less likely to be
married. They are seen as impure, bad cooks, infertile, and
promiscuous.
Religion
Although female circumcision is practiced by Africans of
different religions, a higher percentage of circumcised women
are Islamic. Many Muslims believe the ritual is a religious
obligation. However, female circumcision is not even mentioned
in the Koran, and it is unknown in predominantly Muslim
countries outside of Africa, such as Saudi Arabia and Iraq. What
seems likely is that when Islam came to Africa, its emphasis on
purity became associated with the existing practice of female
circumcision (Abusharaf 1998). Through interactions in societies
that practice female circumcision, the social label of purity
became associated with female circumcision.
Cultural Identity
Advocates of female circumcision charge the increasingly vocal
opponents of the practice with trying to undermine African
culture (Barrie 1996). European colonialism tried to abolish
female circumcision in the first half of this century, but local
people adamantly rejected the interference of invading foreign
cultures and held onto their own traditions as a backlash. They
began to associate female circumcision with their own identity
and cultural traditions. Female circumcision became symbolic of
holding on to their own traditions, and not adapting to a new
culture that tried to impose its own social norms onto another
culture through colonialism.
Solution
The health risks caused by infibulation and excision are of
major concern for African women. The high infant mortality rate
and high maternal death rate associated with infibulation prove
this fact (Bimal- Kanti 1993). There are, however, solutions to
this problem that have been proven to work. In the Netherlands,
a conflict arose because immigrants from areas practicing
infibulation wanted to continue the tradition. However, doctors
refused to practice infibulation because of health risks and
human rights based on their own cultural morality. In the
Netherlands culture, female circumcision is considered
unethical. In response to immigrants' desire to practice their
cultural rights, the Netherlands made a law allowing a specific
kind of female circumcision that had no long term effects, and
was not a health risk. This type of circumcision involves a
small incision made in the skin covering the clitoris. This was
accepted by the immigrants and the doctors, as the immigrants
felt they were still able to practice their cultural traditions,
and doctors did not feel unethical because this kind of
circumcision has no long term effects. The symbols of beauty,
fertility, womanhood, and virginity were still associated with
circumcision. In Africa, governmental laws should be changed
allowing for this type of circumcision. The success this had in
the Netherlands could also be found in Africa. Cultures
following these laws would find a lower infant mortality rate,
as well as a lower death rate for young girls and mothers.
Results from a study in the Nigerian state of Akwa Ibom,
involving survey data from over 400 women, indicate a need for
educational reform. Only 30 percent of the women realized there
was a risk of infection, 17.5 percent the risk of birth
complications, 5 percent the risk of extreme blood loss (Ebong
1997). This shows that many women are ignorant of the health
risks involved in infibulation and excision.
An African women's group started education campaigns in the
Sudan against the harsher, widespread form of circumcision,
called infibulation. Women were informed of the health risks,
including risks to unborn children (Asali 1995). The same form
of circumcision allowed in the Netherlands was introduced in the
Sudan. These women could uphold their cultural traditions
without posing any risk to themselves or their babies. The
result was favorable, some women in societies practicing
infibulation reformed to the form of circumcision practiced by
Bedouin women and in the Netherlands. The circumcisions
practiced in Bedouin culture are the same as those allowed by
the government in the Netherlands. In interviews of twenty- one
Bedouin women, none report any ill effects from this type of
circumcision (Asali 1995). This type of circumcision was also
found favorable by some groups in the Sudan. If such educational
campaigns could be brought to other countries in Africa and in
rural areas, there could be massive reform, as the Netherlands
study and the Sudan study suggest.
Institutional solutions, such as laws allowing for a non-
harmful form of circumcision, should be enforced throughout
Africa. Symbolic interactionism would argue that these laws
would allow the people to keep the meanings associated with
circumcision that define their culture. Educational programs and
campaigns aimed at stopping infibulation and promoting non-
harmful circumcision should also be funded and enforced by the
governments throughout Africa. The people would not have to
change their way of life, or the symbols attached to
circumcision. The symbols would just be transferred to a
different form of circumcision. With these solutions, there
would be a higher life expectancy, a lower infant mortality
rate, and liberation of African women from the painful side
effects caused by infibulation.
Implementation of the solution
My goal is to have educational campaigns in all areas where
infibulation is most rampant. These areas would include Sudan,
Egypt, and Nigeria.
In urban areas, the educational programs would offer courses
to women's groups, in schools, religious centers, and workplaces
dominated by women. Their goals would be to:
1. Educate the women on the harmful health risks caused by
infibulation
2. Introduce the non- harmful form of circumcision
For tribal or rural areas, educational campaigns would focus
on the midwives of each respective cultural group. The midwives
would:
- Be educated on the health risks of
infibulation and excision
- Be trained on the sterilization of
surgical instruments
- Be trained on how to perform the
proposed form of circumcision.
This would allow education of the people
through the midwife. Midwives are highly respected in almost all
cultural groups in Africa, and the people may be more likely to
listen to a midwife of their own group than an outsider (Bell
1998). She could then help others in the group become educated
on the harmful effects of infibulation and excision. Also, the
number of children in school is extremely low in these rural
areas. Because of this, educational campaigns in schools may not
be as successful as having a trained midwife educating a whole
village, with assistance from the educational campaigns. Through
interactions with individuals in society, the midwife would
start the transfer of meanings attached to harmful circumcision
to the proposed form of circumcision.
Evaluation
To evaluate the success of the proposed action, surveys and
interviews would be completed yearly throughout the targeted
areas, Sudan, Egypt, and Nigeria. The surveys would include
women ages six to twenty, as these are the ages most common for
circumcision. The respondents would be chosen randomly from the
targeted areas. These surveys would estimate:
- Women's' knowledge of the health risks
involved in infibulation
- the number of women still being
circumcised yearly
- the type of circumcision practiced
- the feelings associated with both
forms of circumcision.
After a year of educational campaigning,
supporting findings would show that the more harmful version of
female circumcision has declined in the targeted areas, and the
proposed form of circumcision would have replaced infibulation
in those cases. Women would still have the same feelings about
the non- harmful version of circumcision, and associate
infibulation with its harmful effects. Non- supportive data
would show no change or an increase in infibulation. Feelings
about infibulation would have no change, and women would not be
knowledgeable of the health risks involved in infibulation. A
significant change would not be expected after the first year,
especially in rural or tribal areas where law and education may
take longer to implement. Urban areas are predicted to have a
higher success rate. Prior data shows that those living in urban
areas with more education and a higher economic status are more
likely to benefit from educational campaigns. These areas have
already had successful educational training.
Time Line
1. In January, 1999, surveys performed by government funded
educational campaigns of women and girls ages six to twenty
would establish the percentage of women and girls being
circumcised, the type of circumcisions, feelings associated with
the different types of circumcisions, awareness of the health
risks, and would also include other information that describes
the population in terms of economic status, age, ethnicity, and
health. Sudan would be the targeted area. The sample of 200
respondents would be chosen randomly from the targeted areas.
2. In March, 1999, educational campaigns would target the
above mentioned countries and inform women and girls of the
health risks associated with infibulation, and introduce the
other non- harmful form of circumcision. These educational
campaigns would be established in the schools, women's groups,
and religious centers in urban areas. In rural areas, midwives
would also be specially trained, educated, and would assist the
campaigns.
3. Using the same respondents as before, the same survey data
would be collected in March 2000, and yearly after that. If the
numbers of infibulated women have decreased, knowledge of health
risks increased, and negative feelings about infibulation have
increased, this would evaluate the success of the program.
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