Female Genital Mutilation

Female genital mutilation is against the law.

Female genital mutilation or cutting (FGM/C) is against the law in the United States. The United States and many other countries consider FGM/C is a violation of women's rights and a form of child abuse. Federal law makes it a crime to perform FGM/C on a girl younger than 18 or to take or attempt to take a girl out of the United States for FGM/C. In the District any person that performs FGM/C is subjected to fines and or a prison term of up to 10 years and may be sued by the victim.*

Girls and women who have experienced FGM/C are not at fault and have not broken any U.S. laws.

If you suspect that someone under the age of 18 who has experienced or is in imminent danger of experiencing FGM/C you are obligated to report this crime immediately! Do not wait! Use the hotline or online portal to submit a report.

If you think a girl is at risk of FGM/C in the District, contact the District hotline at (202) 671-SAFE or (202) 671-7233. Your call will be confidential and a trained hotline worker will ask you for:

The name, address, age, and gender of the child.
Who is caring for the child and whether other children live in the home.
The nature and extent of the abuse or neglect, as you know it—and any previous abuse or neglect you know about.
Any additional information that may be helpful.

Mandated reporters should use the portal, and identify this an allegation of physical abuse.

*This does not apply to procedures for gender reassignment or procedures that are medically necessary: https://code.dccouncil.gov/us/dc/council/laws/25-322

Overview:

Female genital mutilation or cutting (FGM/C) comprises all procedures that involve partial or total removal of the external female genitalia, or other injury to the female genital organs for non-medical reasons. It involves removing and damaging healthy and normal female genital tissue, and it interferes with the natural functions of girls' and women's bodies. Researchers estimate more than 513,000 girls and women in the U.S. have experienced or are at risk of FGM/C. FGM/C is against the law in the U.S. and is recognized internationally as a violation of the human rights of girls and women. It is nearly always carried out on minors and is a violation of the rights of children.

The practice has no health benefits for girls and women and can result in severe bleeding and problems urinating, and later cysts, menstrual difficulties, infections, as well as complications in childbirth and increased risk of newborn deaths.

FGM/C is sometimes called "female circumcision." FGM/C is not the same as male circumcision.

Types of FGM/C:

Female genital mutilation is classified into 4 major types:

Type 1 (Clitoridectomy): This is the partial or total removal of the clitoral glans (the external and visible part of the clitoris, which is a sensitive part of the female genitals), and/or the prepuce/clitoral hood (the fold of skin surrounding the clitoral glans).

Type 2 (Excision): This is the partial or total removal of the clitoral glans and the labia minora (the inner folds of the vulva), with or without removal of the labia majora (the outer folds of skin of the vulva).

Type 3 (Infibulation): Also known as infibulation, this is the narrowing of the vaginal opening through the creation of a covering seal. The seal is formed by cutting and repositioning the labia minora, or labia majora, sometimes through stitching, with or without removal of the clitoral prepuce/clitoral hood and glans.

Type 4: This includes all other harmful procedures to the female genitalia for non-medical purposes, e.g., pricking, piercing, incising, scraping and cauterizing the genital area.

How is FGM/C a risk for girls and women?

FGM/C has no health benefits and can lead to serious, long-term complications and even death. Immediate health risks include hemorrhage, shock, infection, HIV transmission, urine retention and severe pain.

Psychological impacts can range from a girl losing trust in her caregivers, to longer-term feelings of anxiety and depression.

In adulthood, girls subjected to FGM/C are more likely to suffer infertility or complications during childbirth, including postpartum hemorrhage, stillbirth and early neonatal death.

Immediate complications of FGM/C can include:	Long-term complications can include:
Severe pain	Urinary problems (painful urination, urinary tract infections)
Excessive bleeding (hemorrhage)	Vaginal problems (discharge, itching, bacterial vaginosis and other infections)
Genital tissue swelling	Menstrual problems (painful menstruations, difficulty in passing menstrual blood, etc.)
Fever	Scar tissue and keloid
Infections e.g, tetanus	Need for later surgeries: women with Type 3 might require deinfibulation (opening the infibulated scar to allow for sexual intercourse and childbirth.
Urinary Problems	Psychological problems (depression, anxiety, post-traumatic stress disorder, low self-esteem, etc.).
Wound healing problems
Injury to surrounding genital tissue
Shock
Death
Sexual problems (pain during intercourse, decreased satisfaction, etc.)
Increased risk of childbirth complications (difficult delivery, excessive bleeding, caesarean section, need to resuscitate the baby, etc.) and newborn deaths

How does FGM/C affect pregnancy?

FGM/C does not usually cause problems for a woman during pregnancy, but women who have been cut face unique health risks during childbirth. These include:

Prolonged labor. Women with type 3 FGM/C are at greatest risk for a longer second stage of labor.
Excessive bleeding after childbirth
Higher risk for episiotomy during childbirth. A doctor makes a cut in the perineum, the flesh between the vagina and anus. There is also a higher risk that this flesh will tear on its own during birth. These risks are especially high for women who have had type 3 FGM/C.
Higher risk for cesarean section (C-section). Doctors who are unfamiliar with scarring from FGM/C may suggest a C-section. However, a C-section may not be necessary. Women with type 3 FGM/C may have their vagina safely re-opened (defibulated) during pregnancy or in labor and delivery. But health care providers may not have the experience or training to provide adequate health care for women who have been cut.

Risks to the infant include low birth weight (smaller than 5½ pounds at birth), breathing problems at birth, and stillbirth or early death.

Signs FGM/C May Occur:

A girl or family plans a long holiday overseas to visit family abroad during a school break
Other family members, like a grandmother, mother, aunt or sisters had FGM/C done to them
A girl has an unexpected and/or long absence from school
A girl suddenly starts struggling to keep up in school
A girl expresses intention to run away or does run away from home

Signs FGM/C Has Occurred:

A girl appears to have difficulty or pain when walking, standing or sitting
A girl starts to spend longer time in the bathroom
A girl starts to appear quiet, anxious or depressed
A girl begins to act differently after a break or long absence from school
A girl is reluctant to go to the doctor or her family does not want to bring her to routine medical examinations
A girl reaches out for help, but may not say why out of fear or embarrassment

Why is FGM done?

Different communities and cultures have different reasons for practicing FGM; the reasons are often complex and can change over time. Social acceptability is the most common reason. Families often feel pressure to have their daughter cut so she is accepted by their community. Other reasons may include:

To help ensure a woman remains a virgin until marriage
Hygiene. Some communities believe that the external female genitals that are cut (the clitoris or the labia or both) are unclean.
Rite of passage. In some countries, FGM is a part of the ritual that a girl goes through to be considered a woman.
Condition of marriage. In some countries, a girl or woman is cut in order to be suitable for marriage.
Belief that FGM increases sexual pleasure for the man
Religious duty

No matter why, where or how it is performed, FGM causes extreme physical and psychological harm.

Why is FGM still practiced?

Numerous factors contribute to the persistence of the practice. Yet in every society in which it occurs, FGM/C is an expression of deeply rooted gender inequality.

Some societies see it as a rite of passage. Others use it to suppress a girl’s sexuality or ensure her chastity. FGM/C is not endorsed by Islam or Christianity, but religious texts are commonly deployed to justify it.

Where FGM/C is most prevalent, communities may deem it a prerequisite for marriage or inheritance. This makes it difficult for parents to abandon the practice. Families who don’t participate face ostracism, their daughters at risk of becoming ineligible for marriage.

Resources for Survivors:

Support group for survivors:

Global Woman P.E.A.C.E. Foundation holds support groups for FGM/C survivors, which is guided by a psychologist. If a survivor would like to join, they can contact [email protected]