The medicalisation of FGM refers to situations where only the health risks associated with FGM are addressed, in order to minimise them, and the other issues surrounding the practice are ignored or downplayed. Therefore, medicalisation includes, but is not limited to:
Replacing severe forms of FGM with more symbolic types of cutting.
Healthcare providers performing FGM on girls or women.
Providing access to healthcare facilities, medical equipment or training.
Procedures to re-establish FGM after women have given birth.
Medicalised FGM has increased in a number of countries, including Egypt, Indonesia, Kenya, Malaysia, Nigeria, Northern Sudan, and Yemen, with one-third or more of women in many of these nations having had their daughters cut by trained medical staff.
28 Too Many’s new report investigates the growing involvement of health professionals in FGM and highlights what actions need to be taken to reverse this dangerous trend. Medicalised FGM remains a very risky procedure and does nothing to mitigate the fact that this is a severe form of violence against girls and women, a violation of their human rights and has life-long physical, emotional and sexual implications for survivors.
The medicalisation of FGM is not an appropriate response to FGM. Not only does medicalised FGM still constitute a threat to the health and well-being of women and girls, but also it enables a practice that represents a deeply-rooted form of gender inequality. Furthermore, medicalisation hampers international efforts to eradicate FGM once and for all.
Specifically, it is recommended that action should be taken in the following areas:
Government, Policy Makers and Professional Medical Organisations
1. Condemn all forms of medicalised FGM at local, national and international levels.
2. Involve professional organisations and bodies in advising medical personnel against carrying out FGM and in holding Health Care Professionals (HCPs) accountable for unethical practice. This must include all forms of FGM, including the reinfibulation of women who have previously had FGM, after they give birth.
3. Provide medical staff with relevant training to help them understand the practice and the motivations behind it, so that they can offer appropriate counselling and assistance and advocate against FGM.
4. Provide specific guidelines for HCPs on procedures for suturing wounds resulting from emergency reversals during labour.
5. Support HCPs in learning about the clinical management of FGM survivors and recognising when girls and women are at risk of FGM.
6. Ensure that medical staff, social workers, school nurses and other relevant actors are trained in relation to the laws applicable to FGM and about cultural sensitivity, as well as preventing, detecting and reporting FGM.
7. Provide greater supervision over hospitals in affected areas to deter medical staff from performing the procedure.
8. Enhance punitive law and its enforcement for those who perform FGM, including medical professionals.
9. Draft and implement clear legislation that distinguishes between FGM and cosmetic vaginal surgery.
International Community and NGOs
1. Promote clear statements against all forms of FGM and a zero-tolerance approach to medicalisation of the practice.
2. Develop programmes to tackle FGM that take into account local issues, including addressing the medicalisation of FGM, where this is occurring.
3. Include HCPs in the development and implementation of programmes.
4. Ensure health education on the harm of FGM is within the wider context of FGM as a human-rights issue and a form of gender discrimination.
5. Call upon governments to strengthen their legal protection, reporting and punitive mechanisms to enable effective prosecution of all those including HCPs who perform, facilitate or permit any form of FGM at home or abroad.
Local Community Organisations
1. Assist communities, including immigrants and diasporas, with education on FGM, including medicalisation.
2. Disseminate information about the illegality of the practice as well as the health risks associated with medicalised FGM.
3. Highlight the practice not only as a health issue, but as a human-rights violation that disempowers women.