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Female Genital Mutilation

by Ann S. Botash, MD

Female genital mutilation is ritual removal of part or all of the clitoris and labia.

Female genital mutilation is practiced routinely in parts of Africa (usually northern or central Africa), where it is deeply ingrained as part of some cultures. Women who experience sexual pleasure are considered impossible to control, are shunned, and cannot be married.

The average age of girls who undergo mutilation is 7 years, and mutilation is done without anesthesia. Mutilation may be limited to cutting out part of the clitoris, but in the most extreme form involves removal of the clitoris and labia (termed infibulation), usually followed by sewing the remaining tissue closed except for a small opening for menses and urine. The legs are often bound together for weeks afterward. Traditionally, infibulated females are cut open on their wedding night.

Consequences of genital mutilation include bleeding, infection (including tetanus), scarring, and psychologic problems. Infibulated women have increased susceptibility to AIDS, and childbirth may result in fatal hemorrhage.

Female genital mutilation may be decreasing due to the influence of religious leaders who have spoken out against the practice and growing opposition in some communities.