Special Issues: Female Genital Mutilation

Lancet. 2003 Dec;362:26 – 27

Special Issues: Female Genital Mutilation

Sundby J

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Female genital cutting, circumcision, or mutilation—this controversial practice has many names. Although the procedure resembles something medical, namely surgery, it is most often done by lay people with no formal training in surgical practice or hygiene. The procedure is described and categorised—type I to type IV excision, based on the degree of cutting. The least intrusive form of the procedure is sometimes called sunna, and the most severe, pharaonic circumcision. Thus, this procedure has a medical and a traditional vocabulary.

The cutting of female genitalia for non-medical reasons is a harmful traditional practice. It does not, from a medical point of view, benefit the subject of the procedure. This does not mean, however, that the procedure is never wanted by those who undergo it. In many societies circumcision is a prerequisite for entry to womanhood. It is a cultural phenomenon that affects millions of young women, especially across central Africa, southern Sahara, and some places in the Arab peninsula. Rates vary between regions and ethnic groups. More than 90% of Somali women have the most severe form of the procedure, in which the labia and clitoris are removed and the orifice stitched to leave only a very small opening. Three of four ethnic groups practise cutting in The Gambia, where the clitoris is excised, and sometimes the labia minora as well…

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