Categories, Description and Complications of FGM

Categories

The World Health Organization (WHO, 1997) defined female genital mutilation (FGM) as all procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs whether for cultural or other non-therapeutic reasons. Note that the male equivalent, of even the least severe form of female genital cutting, would be complete amputation of the entire head of the penis. The World Health Organization has classified FGM into four types:

Type I: Excision of the prepuce (less common), with or without excision of part or all of the clitoris (more common).
Type II: Excision of the clitoris with partial or total excision of the labia minora (clitoridectomy).
Type III: Excision of part or all of external genitalia and stitching/narrowing of the vaginal opening (infibulation).
Type IV: Unclassified: includes pricking, piercing or incising of clitoris and/or labia; stretching of clitoris and/or labia, and cauterization by burning of clitoris and surrounding tissue.

Description

Female Genital Mutilation (FGM) has been practiced for several thousand years in almost 30 African and Middle Eastern nations and, to a lesser extent, in parts of Asia.

FGM varies in degree, ranging from cuts around the clitoris (rare), to (more commonly) the entire removal of the clitoris, the removal of the clitoris and labia minora, or the removal of the clitoris and entire labias, with the resulting wound stitched shut. In this last form, infibulation, the opening left is generally no larger than a match head, leaving an insufficient opening for the passage of urine and menses. FGM is often performed in unsterile surroundings with the girl forcibly restrained and cut with rudimentary instruments (razor blade, knife, glass, etc); it is sometimes performed in a medicalized setting.

The age at which a girl is subjected to FGM ranges from seven days old to young adulthood. It is most commonly performed between 2 and 15 years of age. Note that clitoridectomy was practiced as treatment for psychological disorders, mental illness and hysteria in the United States and Europe as late as the 1950's. It has increasingly become prevalent in western countries, especially, for example, in the U.K., where it takes the form of extreme rituals performed on members of populations not previously subjected to it, and as traditional rites imposed by immigrants on immigrant females from practicing cultures.