FGM, Too

What began as one woman’s #MeToo story has become a global conversation about sexual abuse and power. Women around the world in unprecedented numbers are finding the courage to tell the stories of their experiences of sexual harassment and sexual violence.

However, sexual violence is only one form of violence against women. In fact, women around the globe suffer a lifetime of abuse that includes selective deprivation of food and education, child marriage, forced marriage, trafficking, domestic violence and marital rape. While not every woman will experience every type of gender-based violence during her lifetime, most will experience more than one.

As forensic medical evaluators, we’ve seen this trauma firsthand in our work with asylum seekers coming to the United States. And over the last decade, we’ve seen the recurrence of one particular form of violence against women and girls: female genital mutilation / cutting (FGM/C), which involves using a needle or knife to remove parts or all of the external genitals, usually without anesthesia.

MONUSCO / Creative Commons

The World Health Organization has identified four types of FGM/C, which vary in physical severity, destruction of tissue and risk of complications. Worldwide, more than 200 million girls and women in over 30 countries have been cut—and millions more are at risk each year.

When a girl is born into a community that practices FGM/C, she is more likely to be subjected to gender-based harm at every stage of her life—including child marriage, forced marriage and domestic violence. To date, we have conducted over 65 asylum exams for FGM/C affected women from 14 nations, all of whom have been granted protection in the U.S. The common threads of pain, violence and psychological harm as told by our patients are undeniable—and traverse ethnic origins and national boundaries. All of these women were subjected to FGM/C as children, and the majority had a relative or friend who died during their procedure or later from obstetric complications. All of them suffer some long term physical problems as a result of having been cut—including frequent vaginal infections, sexual dysfunction and pain during intercourse.

Performing or facilitating FGM/C on girls under the age of 18 is a federal crime in the U.S., but this practice occurs here as well, though the scope of the problem is hard to define due to the secrecy surrounding the practice. In April 2017, for the first time, a federal grand jury indicted two physicians for conspiring to facilitate and commit FGM/C on two seven-year-old girls in Michigan. The investigation later revealed they may have been responsible for cutting close to 100 young girls from several states; even more alarming, the Centers for Disease Control and Prevention estimates that more than 500,000 girls and women in the U.S. have been affected by or are at risk of undergoing FGM/C.

FGM/C is often defended as a “cultural practice,” but we know that cultural practices can be ethically wrong, and that cultures can change. The crippling practice of foot-binding, once common in China, was seen as a way to increase the marriageability of women—but it was outlawed in 1912, and girls are no longer subjected to this needless, painful and gender-related procedure. Likewise, we should not defend the cutting of girls’ genitals, regardless of degree, in the name of cultural preservation.

There are compelling reasons to question the cutting of any child’s genitals—whether male, female or intersex. We do not believe, however, that all genital cutting should be regarded as equivalent. FGM/C is part of the systematic disregard for women around the world—a practice called “an extreme form of discrimination against women” by WHO and by leaders and human rights organizations across the globe. The United Nations has called for elimination of the practice by 2030. We believe that the efforts to eliminate FGM/C are an integral part of the global fight for equality and respect for all women.

The voices unleashed so powerfully by the 2017 and 2018 Women’s Marches and the #MeToo movement have begun to illuminate the full scope of the violence and discrimination woven into the fabric of women’s lives around the world. The elimination of FGM/C should play prominently in this dialogue. We need to propel society towards the elimination of this practice. It is time for a #MeTooFGM movement.

Dr. Deborah Ottenheimer is the Associate Director of the Human Rights Program at the Icahn School of Medicine at Mount Sinai and lectures extensively on issues around FGM/C. She has trained with the Op-Ed Project.

Dr. Katherine McKenzie 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.

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