- Lisa Feldstein & Federica Broggi
Let’s talk: FGM and Reproductive Health Rights
Ever heard of FGM? Whether you have or not, it would be useful to clarify that this acronym stands for Female Genital Mutilation, sometimes referred to as “female genital cutting”.
In fact, FGM is the non-medical practice of partially or totally removing the external female genitalia. Besides being painful and medically unjustified, this procedure does not benefit the health of those women and girls who undergo FGM, but instead causes severe issues such as infections, which can even lead to death, haemorrhages or genital tissue swelling. Sometimes, it may represent an obstacle during childbirth by increasing the risk of newborn deaths. Reason to bring this issue to light is not only to advocate against this dehumanizing practice, but also to promote a further understanding of the cultural, psychological, health and migration implications it has in our society.
To begin with, in FGM-practising countries like Eritrea, Nigeria, Somalia, Guinea and Ethiopia, female genital cutting is a commonly-accepted social norm. Aiming to control women's sexuality by ensuring virginity before marriage and fidelity during, it has the purpose of increasing male sexual pleasure and women’s acceptance into society. Yet, the international community calls it a human rights violation. Among various motives, one main driver for considering FGM a serious human rights violation is its impact on Reproductive Health Rights. Namely, children undergoing FGM are prone to become infertile due to infections and damage to the fallopian tubes. Later on, many victims of FGM may experience pregnancy in a much more painful way due to damaged tissues of the genital organs. Others may not even be able to be examined during labor due to a tight introitus nor give birth unassisted, as the baby cannot naturally pass through the opening of the vagina. On top of that, giving birth after having undergone FGM can cause severe bleeding and, thus, surgical intervention is required to suture the wounded edges postpartum. This “re-infibulation” procedure is often done at home as many healthcare facilities may be opposing FGM or “infibulation”.
Besides leading to many physical issues, FGM can also have serious psychological implications. In fact, besides anxiety and shock, Post-traumatic Stress Disorder (PTSD) and depression are common consequences. Namely, such trauma stems from the event itself, from recalling the episode, or from people’s reactions when discovering about it. It emanates from the broken trust and feelings of betrayal towards family members who may have organized or participated in the practice, such as the mothers or other relatives who underwent FGM themselves. The girls often do not know what happens to them beforehand, especially because it is practiced on children from 0 to 15 years old. Indeed, even if the child is aware of the practice, the issue of consent remains and usually, these girls are too young to be consulted and have no voice in the matter. Most women tend to isolate themselves, avoid relationships or doctor appointments purposefully to not talk about their FGM experience. Many others feel like they are missing out on important sexual experiences because of the stigma surrounding the practice. With this in mind, one might ask why practicing communities do not put an end to FGM. Well, the pressure on families to be accepted by the community and conform to the idea that FGM is a necessary step before adulthood and marriage is what perpetuates this practice.
Nevertheless, FGM is still an issue many of us consider to be distant from our reality, as it is commonly known for being practiced in non-Western countries; reason for which FGM often lacks attention or media coverage in Western societies. However, female genital cutting is increasingly becoming a reality for many women in Europe.
An estimated 600.000 women in Europe are living with the consequences of FGM and almost 190.000 girls and women are at risk of undergoing the harmful practice in 17 European countries alone. Moreover, every year for the past five years at least 20.000 women and girls from FGM-practicing countries have been seeking asylum in Europe. As many women and young girls flee their countries to avoid FGM or travel to countries where it is illegal, female genital cutting is considered an impactful driver of migration. However, FGM can perpetuate in the new host country, as families who practice FGM may continue following this “norm”, or may pressure others in their community to do so as a way of maintaining cultural traditions.
At an institutional level, FGM may impose obstacles to meeting the protection needs necessary for the concerned women and girls. In fact, many workers in the European asylum systems are not familiar with the practice and it is not uncommon to hear that FGM is not a problem for these women because it is “part of their culture”. Such misconceptions belittle the risks these women face. This leads to an underestimation of the level of help and attention they need, including tailored healthcare support and religio-cultural sensitivity.
Now, where do FGM migrants seek asylum? According to the “Too much Pain” report from UNHCR, between 2008 and 2011, the main destination countries were France, Italy, Malta, Sweden, Germany and the Netherlands. In fact, not only do all EU member states consider FGM a crime, but some even lawfully prosecute the execution of FGM to avoid farther spread of the practice within Europe.
The follow-up question would then be … what should be done about it?
Well, asylum authorities in the European Union should establish more effective procedures to help address the vulnerabilities caused by FGM. As a matter of fact, the asylum process examines whether an applicant has a well-founded fear of persecution based on one or more of the grounds stated in the 1951 Convention relating to the Status of Refugees. As FGM constitutes a form of gender-related persecution, it could grant immediate asylum. Nevertheless, FGM is often a taboo subject refugees avoid talking about, which leads asylum authorities to fail to identify FGM migrants and recognize them as “persecuted” subjects.
Furthermore, this very stigma reinforces existing significant gaps between different vulnerable groups in accessing maternal health care in Europe. Marginalized groups include immigrant populations like asylum seekers and refugees (e.g., originating from countries where FGM is practiced), but also low-income classes, and other socially excluded populations. Supposedly, most countries in Europe have established a universal health care system providing ante- and postnatal care with wide coverage in terms of capacity and services. In reality, the aforementioned groups often have lower access to it. Factors preventing women's access to maternal care include fear and social stigma: for refugees, it can take on the form of fear of deportation, and for others, it may be the fear of being reported to authorities like the police (e.g., sex workers, victims of abuse). Health professionals often lack experience in working with patients that do not conform to the norm, which can result in making estimates of medical conditions with disregard for the actual problems and needs of women in their care. This may also stem from discrimination against women of different ethnicities, religions, and cultures.
What has been done in Europe so far?
First, awareness-raising campaigns and legal proceedings banning the execution of FGM have proven to be effective in preventing its practice in EU member countries. Nonetheless, there is an ongoing necessity of educating affected communities about the risks and consequences of FGM, because that is where FGM is still illegally practiced in Europe. For example, “Coordination Office against FGM_C” in Berlin applies this strategy of working with communities to create long-term change. Furthermore, the UN has launched a global initiative (#MenEndFGM) to eliminate FGM that aims to address men and boys more actively. The goal is to create change by addressing societal gender norms which have, until now, provided the ideal breeding ground for the oppression of women and the continuation of FGM. Some projects aim to establish model protocols for the medical and psychosocial care of people who experienced FGM and the prevention of potential cases.
Now that you know about all the facets of FGM in Europe and the current standard of maternal health care, it is clear that new solutions are needed for the future of women’s rights.
Women have to be actively involved and informed in the decision-making policing their own bodies, which holds for women of all kinds of backgrounds. This can concern women who are survivors of trauma that make childbirth especially difficult, as in the case of FGM, but also women from average middle-class communities, for example.
Overall, we need systematic policies and a more holistic approach to ensure the goal of fair maternal and reproductive health care. Minority populations that are discouraged to seek aid out of fear of prosecution could be helped by the removal of specific legal restrictions; immigrant women could, for instance, receive medical care regardless of their immigrant status.
To conclude, besides disregarding the human dignity of the survivors by treating them as less than human, FGM also collides with the right to physical integrity and compromises women’s chances to become biological mothers. Still, FGM should not only be regarded as a women’s issue, but as everyone’s issue. It is a matter of health and reproductive rights, of oppressive cultural practices which threaten to be passed down through the generations. Lastly, it raises questions about the need to promote bodily integrity and human dignity. The freedom of your own body choices should not be restricted by others, or in the words of a FGM survivor:
“When I was a child I said I don't want to be a woman. Why?! Because it's too painful to be a woman!"
"Let us try and change what it means to be a woman.”
― Waris Dirie, Desert Flower
This article was written for the MD x EuroMUN Printed Edition.