Why is FGM a good choice

Becoming a woman in the agony of genital mutilation

Nomawethu Kelbitsch remembers the first woman affected by FGM who turned to her. The nurse, midwife and psychotherapist has been involved in Graz for years for women - often with a migration background - who are not insured. In 2002 she looked after a young woman from Togo who often suffered from urinary tract infections and severe menstrual pain. During an examination at the Caritas Marian outpatient clinic, it became clear that the woman had undergone female genital mutilation (FGM) of type three - this means that the entire external genitalia was removed. There was only a small opening for urine and menstrual blood.

"The woman asked me if I could explain to her what an uncircumcised woman's body looks like," says Kelbitsch in an interview with STANDARD. Many are unaware that such women even exist. With the help of pictures and anatomical models, Kelbitsch finally explained the appearance and function of the intact female sex organ.

In the meantime, Kelbitsch has cared for hundreds of those affected in collaboration with doctors. If you want to have children, after pregnancy or if you have pain in the genital area, the women seek help: "I talk about FGM very openly and don't wait for the women to tell me about it. If they are not affected themselves, they can pass the information on to other women." tells Kelbitsch.

Millions of people affected

February 6th is the International Day Against FGM, which draws attention to this brutal tradition, which is mainly lived in East and West Africa. Every ten seconds, the genitals of a girl under the age of twelve are mutilated, according to Unicef. Ten percent of the girls bleed to death. Three million girls are at risk of becoming victims of FGM, and it affects 200 million girls and women worldwide.

As early as June, the United Nations expressed fears that an additional two million girls could be affected by FGM due to the coronavirus pandemic. According to the NGO "Orchid Project", increasing numbers have already been reported from East and West Africa. Medical capacity is focused on Covid-19, efforts to end the practice are taking a back seat. Lockdowns would also be a way of being able to carry out genital mutilation unnoticed - and they would prevent important educational work by NGOs. Those affected are more and more left to their own devices.

Schools, churches or other facilities in which girls otherwise often sought protection from FGM had to close in the pandemic. Clinics and practices that were able to provide medical care to those affected after the procedure had to switch their capacities to corona patients.

Social pressure

The medical anthropologist Doris Burtscher prefers the term FGC instead of FGM - i.e. female genital cutting and not mutilation. Because the expression mutilation, in German mutilation, would already stamp and condemn the women concerned, so Burtscher. But there is no good German translation. Burtscher examines cultural perceptions of health and illness on site around the world and works for Doctors Without Borders (Médecins Sans Frontières, MSF). She was in Chad on the subject of FGM, but she was also confronted with it during missions in Sierra Leone and Mauritania. According to their results and experiences, circumcision is based on culture and not on religion.

Many women want to spare their daughters the agony of the operation, but are afraid that their children will be excluded from society and will not be able to marry, explains Burtscher in an interview with STANDARD. Medical or aesthetic criteria are also cited as a reason for FGM: It would itch if the clitoris was not removed, or it just doesn't look that nice. Myths such as the misconception that the clitoris continues to grow and then look like a penis also persist in communities.

Control of women

One of the things that surprised Burtscher in her research was that some of the girls were looking forward to the event. Often they would not have known what to expect or what agony the operation would entail. But in societies in which women are otherwise never in the foreground, this tradition - combined with a festival and again and again with gifts - is often the only moment in women's lives that is about them.

"This is often used to try to control women," says Burtscher. You take away their sexual pleasure, make them more docile. On the question of how FGM - strongly opposed to Doctors Without Borders and for whose implementation the organization does not provide any clean instruments on request - can be curbed, Burtscher mentions several approaches: On the one hand, the problem should not be "medicalized" like them it is called - because then the procedure would simply be transferred to the hospital and not - as intended - be completely abolished. On the other hand, the rite of turning a girl into a woman and celebrating it could still be carried out, just without FGM.

Educating society

Burtscher cites the work of the Senegalese organization "Tostan" as a good approach, which relies on workshops in the village communities and has achieved great success. First, the women are given details about their bodies: How does an orgasm work, how does pleasure arise and why is it beneficial for reproduction and the birth process? Then the men are brought closer to the benefits. Often times, the communities, together with the village elders and religious leaders, have finally decided to abolish FGM. An important signal, as Burtscher says, to influence the existing conventions.

When it comes to prevention, Kelbitsch in Graz focuses above all on strengthening women's self-confidence. In Austria, she prefers to deal with the issue sensitively to the threat of punishment: "Often the women close up and don't even talk about it anymore." In order to put an end to the practice, according to Kelbitsch, midwives, gynecologists and paediatricians in particular could play a major role in providing information: also with regard to men. (Bianca Blei, Noura Maan, 6.2.2021)