Women's Crossroads

Some important news for millions of women in Africa broke today, but you have to peer pretty deep into the recesses of The New York Times to find it.

Results of the first major study of women who have undergone female genital cutting have been released in the respectable British medical journal The Lancet, and the study confirms what women's rights advocates have been saying for years: that FGC is a serious health issue, not just a benign cultural practice that ought to be left alone.

The study was conducted with the cooperation of 28,000 women in six African countries, from 2001 through 2003. There are currently 100 million circumcised women in Africa, and approximately 2 million girls are cut each year, usually in unsanitary conditions without anesthesia or hygienic medical equipment.

The cutting ranges from full excision, where the labia and clitoris are totally removed, with infibulation, in which the vaginal opening is sewn up leaving only a small hole for menstrual blood to escape, to a modified procedure where just the clitoris is removed, or even just the tip of the clitoris rather than the whole organ. In many North African countries, excision is performed on more than 75% of young girls.

Why is this done? The most succinct answer is simply, "tradition." It's always been done, and is considered essential to render girls marriageable, which is of course their main function in the societies that practice FGC most religiously. Anthropologists who have looked more deeply into the custom say it has something to do with removing the "male" side of women (the clitoris resembling a miniature penis), so that they will be more docile.

When full excision and infibulation, the procedure serves as an effective chastity belt for young girls, since intercourse becomes excruciatingly painful. I recently read an oral history by a Somali woman, who spoke movingly of the pain of being "devirgined," as she put it; not by her husband, in her case, but by a rapist.

But the largescale study released today provides more than anecdotal evidence of the dangers and pain of FGC.

Elizabeth Rosenthal reported today in The Times that "The study found that the women who had undergone genital cutting of any degree of severity and their babies were more likely to die during childbirth. More extensive genital cutting produced the highest rates of maternal and infant death during childbirth, even many years later.

"The lesser forms of cutting caused about a 20 percent increase in death rates, while extensive procedures caused increases of more than 50 percent.

"By almost all measures studied by the World Health Organization, a history of genital cutting put both mother and baby at risk. Mothers who had had the procedure had longer hospital stays, experienced more blood loss, and were more likely to need a Caesarean section. Babies were nearly twice as likely to require resuscitation at birth.

"The researchers noted that the study almost certainly underestimated the potential for death and damage, because it only tracked women who delivered their babies in hospitals.

"Many women in the African nations where genital cutting is practiced deliver their babies at home, where typically it is not possible to treat medical complications like severe bleeding or to resuscitate an ailing newborn."

One of the most frightening things about this "tradition" is that it is perpetuated by women themselves. Older women do the cutting of young girls (sometimes as young as 5 years old) who are brought to the knife by their own mothers. Alice Walker has written powerfully of this phenomenon in her novel Possessing the Secret of Joy, required reading for anyone interested in this issue.

In the course of discussing FGC in my global feminisms classes, I've come to realize that Western women also engage in harmful cultural practices that we pass on to our daughters unthinkingly. Like Chinese women binding their daughters' feet, we accept high heels as "sexy," and pass on this attitude to our children. We also accept the "thin is beautiful" myth, and smile indulgently as our adolescent daughters begin the first of a lifetime of diets. There are undoubtedly many other more subtle cultural practices that we condone without even thinking about their potentially harmful effects.

But female genital cutting does seem like a tradition that's on another level entirely. Cutting off the clitoris, a woman's organ of sexual pleasure? Sewing up the vaginal opening, so that a man must "break in" in order to have sex with his wife? Condemning young women to a lifetime of high risk during pregnancy, in cultures that regard motherhood as the highest calling for women?

Elizabeth Rosenthal doesn't even mention the worst side effect of FGC, fistulas, in which the walls separating the vagina from the urethra and/or bowels are torn during the difficult childbirth that is routine for a "circumcised" woman. Although these tears can be repaired with operations, such medical care is beyond the reach of most African women, who are condemned to a lifetime of ostracization because they can no longer control their bladders or bowels. How awful is that?

I am glad to see that a largescale study has finally been undertaken; glad to see the issue receiving mention in the mainstream press, however buried behind more pressing concerns like the impact of of bone growth drugs on jaw disease (placed on today's front page of The Times, even though the problem affects only 1 to 10 percent of the 500,000 American cancer patients who take the drugs because their disease is affecting their bones).

Some two million African girls come under the circumciser's knife every year. It's now been medically proven that this practice is almost unbelievably harmful.

What is being done? U.N. agencies like the World Health Organization, UNICEF and UNIFEM have been working on this issue for the past ten years or more, aiding local women's groups in providing more educational awareness, as well as pressuring governments to ban the practice (Senegal leads the way, the first African nation to ban excision). American women who care can support the work of these agencies, as well as other NGOs like Women for Women International, which is raising money now to open an office in Sudan.

There's every reason to hope and expect that this practice will come, in our lifetimes, to be relegated to the closet of abandoned curiosities, like foot-binding and lobotomies for "hysterics." The harder we push for it, the faster that day will come.