FEMALE GENITAL MUTILATION/CUTTING A STATISTICAL EXPLORATION A STATISTICAL EXPLORATION fci ACKNOWLEDGEMENTS Female genital mutilation/cutting (FGM/C) is a of structural inequality and violates universally traditional practice with severe health conse- recognized human-rights principles of equality quences for girls and women. It occurs mainly and non-discrimination. in countries along a belt stretching from Senegal in West Africa to Somalia in East Africa and to By providing a statistical analysis and background, Yemen in the Middle East, but it is also practised this publication also complements the November in some parts of South-East Asia. Reports from 2005 Innocenti Digest on FGM/C. Europe, North America and Australia indicate that it is practised among immigrant communities as The publication of Female Genital Mutilation/ well. As with many ancient practices, FGM/C is Cutting: A Statistical Exploration is the result of carried out by communities as a heritage of the a cooperative effort between UNICEF’s Strategic past and is often associated with ethnic identity. Information Section (SIS/DPP) and its Child Communities may not even question the practice Protection Section (CP/PDF). The study was or may have long forgotten the reasons for it. coordinated by Edilberto Loaiza (SIS/DPP). Rada Noeva (SIS/DPP consultant) researched and pre- Since the early 1990s, data on FGM/C have pared a fi rst draft of this paper, and Claudia Cappa been collected through a separate module of actively participated in the fi nal stages (SIS/DPP). the Demographic and Health Surveys (DHS) Diakathe Ngagne (SIS/DPP) provided support for implemented by Macro International. The FGM/C data processing and tabulations. Valuable insight module has yielded a rich base of data comparable and comments were provided by Maria Gabriella over 19 countries. We wish to thank the DHS De Vita (CP/PD). Special thanks to Catherine project for making these data available. Langevin-Falcon, the editor. Data have also been collected through the For further information or to download these and Multiple Cluster Indicator Surveys (MICS) using a other publications, please visit the website at module similar to that of DHS. The MICS FGM/C www.childinfo.org. module has been adjusted to the DHS module and will be implemented during the third round of Extracts from this publication may be freely repro- surveys (MICS-3) in 2005–06. duced, provided that due acknowledgement is given to the source and to UNICEF. The Strategic The prime objective of this publication is to Information Section and Child Protection Section improve an understanding of issues relating to (UNICEF, New York) invite comments on the con- FGM/C in the wider framework of gender equal- tent and suggestions on how it could be improved ity and social change. FGM/C is a manifestation as an informational tool. ISBN-13: 978-92-806-3941-4 ISBN-10: 92-806-3941-2 Cover photo: © UNICEF/HQ01-0099/Stevie Mann Text: © The United Nations Children’s Fund (UNICEF), 2005 FEMALE GENITAL MUTILATION/CUTTING 2005A STATISTICAL EXPLORATION FEMALE GENITAL MUTILATION/CUTTING A Statistical Exploration 2005 CONTENTS I. INTRODUCTION . 1 ANNEXES (continued) A violation of rights . 1 Table 2A: Percentage of women 15–49 years Legal instruments: International and domestic. 2 old with at least one daughter circumcised, by UNICEF and FGM/C . 2 place of residence and age group . 35 II. OBJECTIVE AND DATA SOURCES . 3 Table 2B: Percentage of women 15–49 years III. GLOBAL PREVALENCE RATES . 4 old with at least one daughter circumcised, by Generational trends. 7 education level and household wealth. 36 Table 2C: Percentage distribution of women IV. SOCIO-ECONOMIC AND DEMOGRAPHIC 15–49 years old with at least one daughter DIFFERENTIALS AFFECTING FGM/C circumcised, by ethnicity and religion . 37 PREVALENCE RATES . 7 Age . 7 Table 3: Percentage distribution of women 15–49 Education . 9 years old who have undergone FGM/C, by type Place of residence. 9 of practitioner. 38 Religion . 10 Table 4: Percentage distribution of women Ethnicity . 11 with at least one daughter who has undergone Household wealth. 12 FGM/C, by type of practitioner . 39 V. ANALYSIS BY TYPE OF Table 5: Percentage distribution of women PRACTITIONER . 13 who have undergone FGM/C, by type. 40 VI. ANALYSIS BY TYPE OF FGM/C . 15 Table 6: Percentage distribution of women with at least one daughter who has undergone VII UNDERLYING CAUSES AND FGM/C, by type . 41 ATTITUDES . 17 Beliefs vs. practice: Support of FGM/C. 17 Table 7A: Percentage of women 15–49 years Socio-economic and demographic old who believe FGM/C should continue, by differentials . 19 place of residence and age group . 42 Women’s empowerment and support Table 7B: Percentage of women 15–49 years for FGM/C . 21 old who believe FGM/C should continue, by Multivariate analysis . 26 education level and religion . 43 VIII. CONCLUSIONS AND Table 8: Percentage of women and men who RECOMMENDATIONS . 28 support FGM/C and reasons for their support. 44 REFERENCES . 30 Table 9: Attitudes towards the continuation of FGM/C and variables of women’s ANNEXES . 31 empowerment. 45 Table 1A: Prevalence (%) of FGM/C among Table 10: Odds ratio: Likelihood of the women 15–49 years old, by place of residence discontinuation of FGM/C, according to and age group . 32 background characteristics . 46 Table 1B: Prevalence (%) of FGM/C among Table 11: FGM/C questions included in women 15–49 years old, by education level DHS and MICS questionnaires for women and household wealth . 33 and men . 48 Table 1C: Prevalence (%) of FGM/C among women 15–49 years old, by ethnicity and religion . 34 I. INTRODUCTION The procedure is generally carried out on girls between the ages of 4 and 14; it is also done to “Even though cultural practices may appear infants, women who are about to be married and, senseless or destructive from the standpoint of sometimes, to women who are pregnant with others, they have meaning and fulfi l a function their fi rst child or who have just given birth. It is for those who practise them. However, culture often performed by traditional practitioners, includ- is not static; it is in constant fl ux, adapting and ing midwives and barbers, without anaesthesia, reforming. People will change their behaviour using scissors, razor blades or broken glass. when they understand the hazards and indignity of harmful practices and when they FGM/C is always traumatic. Immediate compli- realize that it is possible to give up harmful cations include excruciating pain, shock, urine practices without giving up meaningful aspects retention, ulceration of the genitals and injury to adja- of their culture.” cent tissue. Other complications include septicaemia (blood poisoning), infertility and obstructed labour. — Female Genital Mutilation, A joint Haemorrhaging and infection have caused death. WHO/UNICEF/UNFPA statement, 1997 A violation of rights Female genital mutilation/cutting (FGM/C) is “the partial or total removal of the female external FGM/C is a fundamental violation of human rights. genitalia or other injury to the female genital organs In the absence of any perceived medical neces- for cultural or other non-therapeutic reasons.”1 sity, it subjects girls and women to health risks and It is estimated that more than 130 million girls has life-threatening consequences. Among those and women alive today have undergone FGM/C, rights violated are the right to the highest attain- primarily in Africa and, to a lesser extent, in able standard of health3 and to bodily integrity.4 some countries in the Middle East. Furthermore, it could be argued that girls (under 18) cannot be said to give informed consent to such a The World Health Organization (WHO) groups potentially damaging practice as FGM/C. FGM/C into four types: 1. Excision of the prepuce [the fold of skin sur- FGM/C is, further, an extreme example of dis- rounding the clitoris], with or without excision crimination based on sex. The Convention on the of part or the entire clitoris. Elimination of All Forms of Discrimination against Women defi nes discrimination as “any distinction, 2. Excision of the clitoris with partial or total exclusion or restriction made on the basis of sex excision of the labia minora [the smaller inner which has the effect or purpose of impairing or folds of the vulva]. nullifying the recognition, enjoyment or exercise 3. Excision of part or all of the external genitalia by women, irrespective of their marital status, on and stitching or narrowing of the vaginal open- a basis of equality of men and women, of human ing (infi bulation). rights and fundamental freedoms in the political, economic, social, cultural, civil or any other fi eld” 4. Unclassifi ed, which includes pricking, piercing (article 1). Used as a way to control women’s or incising of the clitoris and/or labia; stretch- sexuality, FGM/C is a main manifestation of gender ing of the clitoris and/or labia; cauterization by inequality and discrimination “related to the his- burning of the clitoris and surrounding tissue; torical suppression and subjugation of women,”5 scraping of tissue surrounding the opening denying girls and women the full enjoyment of their of the vagina (angurya cuts) or cutting of the rights and liberties. vagina (gishiri cuts); introduction of corrosive substances or herbs into the vagina to cause As stated in the Convention on the Rights of bleeding or to tighten or narrow the vagina; the Child, all actions concerning children should and any other procedure that can be included be undertaken in the best interests of the child in the defi nition of female genital mutilation (article 3.1). The Convention further asserts that noted above.2 children should have the opportunity to develop physically in a healthy way, receive adequate medi- cal attention and be protected from all forms of A STATISTICAL EXPLORATION 1 violence, injury or abuse.