When Jane was 12, she was taken by force by some older women in her village in Guinea to a room outside her home and held down while her genitals were cut. She couldn’t see the instruments they used; she simply felt searing pain.
Her mother was not there, and they had never discussed this procedure performed on young girls in her community called female genital mutilation (FGM). Jane, whose name has been changed for confidentiality, later found out that her family wholeheartedly supported the practice.
While FGM is traditional in some cultures, there are no medical benefits to the procedure, and it violates a girl’s human rights. According to a recent UNICEF report, FGM is practiced in 30 countries, and at least 200 million girls and women alive today have undergone FGM.
The International Day of Zero Tolerance for FGM last month highlighted the importance of eliminating this practice. As we contemplate the gains women have made during March’s Women’s History Month, we must recognize that girls worldwide continue to be at risk for lasting damage through FGM.
For more than a decade, I’ve been providing medical examinations for those seeking asylum in the U.S., and regularly evaluate those applying because they suffered FGM in their country. Their brutal stories are difficult to hear.
Jane was soft-spoken when she described her childhood ordeal. Her initial wounds healed slowly, but once she was married, sex was always painful and she has not been able to experience pleasure. She still experiences sadness and anxiety when recalling her past.
When FGM occurs, genitals are cut and sometimes removed. It is usually carried out on prepubescent girls. If the clitoris is excised, a woman’s ability to experience sexual pleasure can be diminished permanently. The acute complications can include bleeding, infection, and even death; potential long-term complications include complications in childbirth, recurrent urinary tract infections, scarring, hepatitis and HIV, and depression.
The examination revealed that Jane’s clitoris and labia minora had been removed, which is defined by the World Health Organization as type 2 FGM, one of four types.
There are many obstacles to changing this practice. For thousands of years, families have supported FGM and genuinely believe it is best for their daughters. FGM is a deeply embedded cultural norm in some societies, although there are no religious scriptures to support it. Some communities believe the practice keeps girls and women pure before, and faithful after, marriage. A girl who does not undergo FGM may be considered dirty, and she can be ostracized. And if a family doesn’t allow their daughter to undergo FGM, the community may shun them. There can even be financial consequences to the businesses of the parents of girls who object to FGM. Sometimes a girl won’t be considered to be marriageable, depriving her of another basic human experience.
But social traditions can change, and it is possible to eliminate FGM by 2030, which is the goal of the U.N. Until there is greater awareness, girls will continue to be frightened and hurt. Physicians can be powerful advocates for speaking out against FGM. Organizations such as UNICEF and the Orchid Project have worked to decrease FGM significantly in the last 30 years, but with population growth, the absolute numbers of girls harmed will continue to increase we don’t stop the practice.
I was deeply gratified when Jane and her family were granted asylum in the U.S. She knows she and her children are safe in a country that condemns FGM and is grateful that her daughters will never have to endure the pain and trauma she experienced as a girl.
Together with the medical community, families worldwide need to support the complete elimination of this practice, and keep girls safe, healthy, and unharmed.
Katherine McKenzie, M.D., is on the faculty of Yale School of Medicine and is the director of the Yale Center for Asylum Medicine. She is a Public Voices Fellow with The OpEd Project.