On 6 February the world commemorated the International Day of Zero Tolerance for Female Genital Mutilation (FGM). On this day, various stakeholders united to affirm the right of every girl and woman to be free from this form of gender-based violence, and Unisa’s Institute for Gender Studies (IGS), in solidarity with this campaign, affirmed the institution’s support for Zero Tolerance for FGM. In this article, two IGS researchers discuss the nature and effects of FGM, and initiatives to counter it.

Leandra Joubert, IGS Researcher

Female genital mutilation, also known as female circumcision or female genital cutting (FGC), refers to any practice that includes the purposeful and non-medical removal of all or part of the external female genitalia or any harm done to the female genital organs for cultural or religious reasons. It is an act that amounts to violence against women and girls, a human rights violation in need of urgent abolishment.

According to the World Health Organization (WHO), the global prevalence of FGM is above 200 million girls and women with its incidence at about three million girls per year. It is especially prevalent in 30 countries across Africa, the Middle East and Asia where FGM is deeply entrenched into the cultural practices of various communities in those regions.

In South Africa, although FGM is not as prevalent, recent reports indicate that the incidence of FGM is slowly growing. Evidence suggests that locally FGM is actually practised among some Venda, Indian, and Southern Ndebele communities, as well as by some immigrants, refugees and foreign nationals. Furthermore, a newspaper article from January 2023 showed that FGM is also practised by some Sotho communities in Matatiele.

According to the WHO, four types of FGM have been identified:

• Type 1 – clitoridectomy, where either the clitoris, clitoral hood or its attachments are cut and discarded
• Type 2 – excision, involves the removal of both labia majora and minora
• Type 3 – infibulation, which is the removal of the clitoris and labia minora with the partial stitching of the labia majora together
• Type 4 includes the burning, stretching, pricking, piercing, scraping, or singeing of the genitalia

FGM is quite often performed by traditional circumcisers; however, reports also show that in several parts of the world, medical FGM is performed by trained medical service providers and is also on the rise. FGM is believed to discourage sexual behaviour and elevate the female’s social status as it is often viewed as a rite of passage into womanhood and has deep historical and social origins.

FGM – besides being a gross human rights violation – has numerous negative consequences. Physical and psychological consequences include the following:

Physical consequences

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  Dr Sibusiso Mkwananzi, IGS Senior Researcher

  Intense physical and psychological distress and pain; in some cases, the pain can result in death.
• Severe blood loss when the clitoris is removed that can lead to anaemia and even death.
• Long-term effects due the surgery include frequent urinary tract and vulvovaginal infections, infertility, septicaemia and the spreading of viruses like hepatitis B and C or HIV/AIDS, which are all possible outcomes of dermoid cysts.
• Infibulation can cause urine retention, leading to pain, infections and discomfort.
• A female’s health may be jeopardised by vaginal infections or an abnormal discharge, which can exacerbate menstrual symptoms such as painful periods and difficulty passing menstrual blood, increasing the risk of sepsis.
• Scar tissue or keloid scarring (where the scar tissue is particularly thick) might complicate childbirth.
• Intercourse-related cutting (after type 3), also known as de-infibration, is associated with an increased risk of infection, mortality and scarring.
• An increase in pain and lowered physical satisfaction. This is true for all forms of FGM since the body may have less flexibility, making intercourse and childbirth challenging.
• Deliveries with type 3 have specific problems. There is an increased danger of the infant being in distress, significant bleeding, longer labour and neonatal mortality.
• The possibility of miscarriage and stillbirth increases.
• Increased maternal mortality rates throughout pregnancy and delivery.

Psychological consequences

• Post-traumatic stress disorder (PTSD) can result from the excruciating agony, as well as a mistrust of caregivers and other people.
• PTSD may have an effect on appetite, sleep, the ability to function and thinking. Intrusive and constant thoughts of the traumatic event impact concentration, leading to feelings of numbness and the feeling of dissociation.
• Sadness and low self-esteem are PTSD-related mental health issues that can coexist with other mental health issues.
• In public, vaginal smell and discharge might lower one’s confidence and self-esteem.
• Difficulties in relationships, including an increase in distrust.
• Anxiety disorders like phobia and somatisation, where psychological anguish is shown externally in the form of physical symptoms, can manifest and have distressing effects on an individual.
• Behaviours such as self-injury and/or contemplation of suicide are more prevalent as stress, worry, lack of self-confidence, and general hopelessness are common symptoms.

In light of the above negative consequences, in 2008, the World Health Assembly passed resolution WHA61.16 on the elimination of FGM, emphasising the need for concerted action in all sectors including health, education, finance, justice and women’s affairs towards its elimination. South Africa has enacted subsidiary legislation to address FGM. The Promotion of Equality and Prevention of Unfair Discrimination Act (Equality Act) Section 8(b) outlaws discrimination of any person on the grounds of gender and culture, including FGM. Under Section 12(2) (a), the Children’s Act explicitly prohibits genital mutilation or circumcision of female children. Unfortunately, the enforcement of this legislation appears to be ineffective in combating the practice effectively.

FGM, although promoted as a cultural practice, violates various constitutionally enshrined rights provided for in the Bill of Rights. Thus the South African government must take all appropriate measures to curb the practice. As underscored in Sections 30 and 31(2) of the Constitution, cultural practices that are in violation of the provisions under the Bill of Rights are null and void and thus illegal. FGM is inconsistent with the Constitution because it infringes on the right to human dignity, health, and privacy and leads to physical harm and can infringe on the right to life.

The future of South African girls and women requires us to protect them from all practices that have the potential to hamper the free and full enjoyment of their rights. Therefore, we recommend that FGM be incorporated as a variable into the South African demographic and health survey like other countries with the phenomenon to collect data on it. This would ensure better monitoring and assessment of FGM nationwide. Additionally, we appeal to our government and law enforcement agents as well as action activists, feminist groups, other organisations and stakeholders that are committed to the cause of upholding the human rights of girls and women, to stand with us in strongly condemning this practise.

* By Dr Sibusiso Mkwananzi, IGS Senior Researcher, and Leandra Joubert, IGS Researcher