Female Genital Mutilation/Cutting
- 1 History of terminology
- 2 World Health Organization categorization
- 3 Prevalence
- 4 Cultural and religious aspects
- 5 Medical consequences
- 6 Sexual consequences
- 7 Attempts to end the practice of FGC
- 8 Laws and prevalence
- 9 See Also
- 10 References
History of terminology
Different terms are used to describe female genital surgery. The procedures were commonly referred to as female circumcision, but the terms female genital mutilation (FGM) and female genital cutting (FGC) are now dominant throughout the international community. Opponents of the practice often use the term female genital mutilation, whereas groups that oppose the stigma of the word "mutilation" prefer to use the term female genital cutting. A few organizations have started using the combined term female genital mutilation/cutting (FGM/C).
Several dictionaries, including medical dictionaries, define the word circumcision as applicable to procedures performed on females. Morison et al. state that female circumcision is a commonly used term for the procedures. Cook states that historically, the term female circumcision was used, but that "this procedure in whatever form it is practiced is not at all analogous to male circumcision." Shell-Duncan states that the term female circumcision is a euphemism for a variety of procedures for altering the female genitalia. Toubia argues that the term female circumcision "implies a fallacious analogy to nonmutilating male circumcision".
Female genital mutilation
The term female genital mutilation gained growing support in the late 1970s. The word "mutilation" not only established clear linguistic distinction from male circumcision, but it also emphasized the gravity of the act. In 1990, this term was adopted at the third conference of the Inter-African Committee on Traditional Practices Affecting the Health of Women and Children (IAC) in Addis Ababa. In 1991, the World Health Organization (WHO), a specialized agency of the United Nations (UN), recommended that the UN adopt this terminology; subsequently, it has been widely used in UN documents.
In this context, the term female circumcision was thus predominantly replaced by the term female genital mutilation: The extensive literature on the subject, the support of international organizations, and the emergence of local groups working against the continuation practices appear to suggest that an international consensus has been reached. The terminology used to refer to these surgeries has changed, and the clearly disapproving and powerfully evocative expression of "female genital mutilation" has now all but replaced the possibly inaccurate, but relatively less value laden-term of "female circumcision". 
Female genital cutting
Because the term female genital mutilation has been criticized for increasing the stigma associated with female genital surgery, some groups have proposed an alteration, substituting the word "cutting" for "mutilation." According to a joint WHO/UNICEF/UNFPA statement, the use of the word "mutilation" reinforces the idea that this practice is a violation of the human rights of girls and women, and thereby helps promote national and international advocacy towards its abandonment. They state that, at the community level, however, the term can be problematic; and that local languages generally use the less judgmental "cutting" to describe the practice. They also feel that parents understandably resent the suggestion that they are "mutilating" their daughters. In this spirit, in 1999, the UN Special Rapporteur on Traditional Practices called for tact and patience regarding activities in this area and drew attention to the risk of "demonizing" certain cultures, religions, and communities. As a result, they claim, the term "cutting" has increasingly come to be used to avoid alienating communities. 
In 1996, the Uganda-based initiative REACH (Reproductive, Educative, And Community Health) began using the term female genital cutting, observing that female genital mutilation may "imply excessive judgment by outsiders as well as insensitivity toward individuals who have undergone some form of genital excision." While some international organizations, such as the UN and the WHO, continue to use the earlier term of female genital mutilation, a number of agencies, like UNICEF, now use the term female genital mutilation/cutting (FGM/C).
World Health Organization categorization
There are several distinct practices of FGC that range in severity, depending on how much genital tissue is cut away. Four major types have been categorized by the WHO (see Diagram 1), although there is some debate as to whether all common forms of FGC fit into these four categories, as well as issues with the reliability of reported data.
The WHO defines Type I FGM as the partial or total removal of the clitoris (clitoridectomy) and/or the prepuce (clitoral hood); see Diagram 1B. When it is important to distinguish between the variations of Type I mutilation, the following subdivisions are proposed: Type Ia, removal of the clitoral hood or prepuce only; Type Ib, removal of the clitoris with the prepuce. In the context of women who seek out labiaplasty, there is disagreement among doctors as to whether to remove the clitoral hood in some cases to enhance sexuality or whether this is too likely to lead to scarring and other problems.
The WHO's definition of Type II FGM is "partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora. When it is important to distinguish between the major variations that have been documented, the following subdivisions are proposed: Type IIa, removal of the labia minora only; Type IIb, partial or total removal of the clitoris and the labia minora; Type IIc, partial or total removal of the clitoris, the labia minora and the labia majora. This type of FGC is also called khafd, meaning reduction in Arabic.[ Citation needed ]
Type III: Infibulation with excision
The WHO defines Type III FGC as "excision of part or all of the external genitalia and stitching/narrowing of the vaginal opening" (infibulation). It is the most extreme form of FGC, and accounts for about 10% of all FGC procedures. Infibulation is also known as "pharaonic circumcision."[ Citation needed ]
In a study of infibulation in the Horn of Africa, Pieters observed that the procedure involves extensive tissue removal of the external genitalia, including all of the labia minora and the inside of the labia majora. The labia majora are then held together using thorns or stitching. In some cases the girl's legs have been tied together for two to six weeks, to prevent her from moving and to allow the healing of the two sides of the vulva. Nothing remains but the walls of flesh from the pubis down to the anus, with the exception of an opening at the inferior portion of the vulva to allow urine and Menstruation/menstrual blood to pass through, (see Diagram 1D). Generally, a practitioner deemed to have the necessary skill carries out this procedure, and a local Anesthesia|anestheticis used. However, when carried out "in the bush," infibulation is often performed by an elderly matron or midwife of the village, with no anesthesia used.
A reverse infibulation can be performed to allow for sexual intercourse or when undergoing labor, or by female relatives, whose responsibility it is to inspect the wound every few weeks and open it some more if necessary. During childbirth, the enlargement is too small to allow vaginal delivery, and so the infibulation must be opened completely and restored after delivery. Again, the legs are sometimes tied together to allow the wound to heal. When childbirth takes place in a hospital, the surgeons may preserve the infibulation by enlarging the vagina with deep episiotomies. Afterwards, the patient may insist that her vulva be closed again.
This practice increases the occurrence of medical complications due to a lack of modern medicine and surgical practices.
A five-year study of 300 women and 100 men in Sudan found that "sexual desire, pleasure, and orgasm are experienced by the majority of women who have been subjected to this extreme sexual mutilation, in spite of their being culturally bound to hide these experiences. 
Most advocates of the practice continue to perform the procedure in adherence to standards of beauty that are very different from those in the west. Many infibulated women will contend that the pleasure their partners receive due to this procedure is a definitive part of a successful marriage and enjoyable sex life. [ Citation needed ]
Type IV: Other types
There are other forms that are collectively referred to as Type IV and may not involve any tissue removal at all. This includes a diverse range of practices, including pricking the clitoris with needles, burning or scarring the genitals as well as ripping or tearing of the vagina or introducing herbs into the vagina to cause bleeding and a narrowed vaginal opening.
The World Health Organization estimates that over between 100 and 140 million women worldwide have been affected by some form of FGC, with the potential of 3 million procedures being performed every year.
Female genital cutting is today mainly practiced in African countries. It is common in a band that stretches from Senegal in West Africa to Somalia on the East coast, as well as from Egypt in the north to Tanzania in the south. It is also practiced by some groups in the Arabian peninsula. The country where FGC is most prevalent is Somalia, followed by Egypt, Sudan, Ethiopia, and Mali. Among ethnic Somali women, infibulation is traditional and nearly universal. Recent figures estimate that 90 percent of Egyptian women have undergone FGC. Egypt recently passed a law banning FGC.
Whilst FGC is widely practiced out in the open by Africans of all faiths, it is practiced in secrecy in some parts of the Middle East. In the Arabian peninsula, Sunna circumcision is usually performed, especially among Arabs (ethnic groups of African descent are more likely to prefer infibulation). The practice occurs particularly in northern Saudi Arabia, southern Jordan, and Iraq. In the Iraqi village of Hasira, a recent study found that 60 percent of the women and girls reported having had the procedure.[ Citation needed ] Prior to the study, there had been no solid proof of the procedure's prevalence. There is also circumstantial evidence to suggest that FGC is practiced in Syria, western Iran, and southern Turkey.
The practice can also be found among a few ethnic groups in South America and very rarely in India. In Indonesia, the practice is fairly common among the country's Muslim women; however, in contrast to Africa, almost all are Type I or Type IV, the latter usually involving the symbolic pricking of blood release.
Due to immigration, the practice has also spread to Europe, Australia and the United States. Some tradition-minded families have their daughters undergo FGC whilst on vacation in their home countries. As Western governments become more aware of FGC, legislation has come into effect in many countries to make the practice of FGC a criminal offense. In 2006, Khalid Adem became the first man in the United States to be prosecuted for mutilating his daughter.[ Citation needed ]
Cultural and religious aspects
The traditional cultural practice of FGC predates both Islam and Christianity. A Greek papyrus from 163 B.C. mentions girls in Ancient Egypt undergoing circumcision and it is widely accepted to have originated in Egypt and the Nile valley at the time of the Pharaohs. Evidence from mummies have shown both Type I and Type III FGC present.
Although FGC is practiced within particular religious sub-cultures, FGC transcends religion as it is primarily a cultural practice. It is now generally recognized that even though a number of the countries where female genital surgeries are found are predominantly Muslim, the practice is not prescribed by Islam and are, in fact, found among non-Muslim groups such as Coptic Christians of Egypt, several Christian groups in Kenya, and the Falasha Jews of Ethiopia. In CDI, the prevelance is 80 percent among Muslims, 40 percent among those with no religion and 15 percent among Protestants, and in Sudan the prevalence is highest among Muslim women.[ Citation needed ] In Kenya, by contrast, prevalence is highest among Catholics and Protestants compared with other religious groups.[ Citation needed ] Thus, there is no unequivocal link between religion and prevalence.[ Citation needed ] UNICEF stated that when "looking at religion independently, it is not possible to establish a general association with FGM/C status."[ Citation needed ] The arguments used to justify FGC vary; they range from health-related to social benefits:
- maintenance of cleanliness
- maintenance of good health
- preservation of virginity
- enhancement of fertility
- prevention of promiscuity
- increase of matrimonial opportunities
- pursuance of aesthetics
- improvement of male sexual performance and pleasure
- promotion of social and political cohesion[ Citation needed ]
Medical justifications offered by cultural tradition are regarded by scientists and doctors as unsubstantiated. Some African societies consider FGC part of maintaining cleanliness as it removes secreting parts of the genitalia. Vaginal secretions, in reality, play a critical part in maintaining female health. The Mossi of Burkina Faso and the Ibos of Nigeria believe that babies die if they touch the clitoris during birth.[ Citation needed ] In some areas of Africa, there exists the belief that a newborn child has elements of both sexes. In the male body the foreskin of the penis is considered to be the female element. In the female body the clitoris is considered to be the male element.[ Citation needed ] Hence when the adolescent is reaching puberty, these elements are removed to make the indication of sex clearer.
In years past, doctors advocating or performing these procedures sometimes claimed that girls of all ages would otherwise engage in excessive masturbation and be "polluted" by the activity, which was referred to as "self-abuse".
Social justifications similarly lack scientific evidence. FGC advocates have claimed the practice cures females of a myriad of psychological diseases including clinical depression, hysteria, insanity and kleptomania. FGC is often used as a means of control over female virtue. FGC is often used as a means of preservation and proof of virginity, and is regarded in many societies as a prerequisite for honorable marriage. Type III FGC is often used in these societies, and the husband will sometimes cut his bride's scar tissue open after marriage to allow for sexual intercourse. Heavy stigma lies on men who marry an uncircumcised woman. Women who have had genital surgeries are often considered to have higher status than those who have not and are entitled to positions of religious, political and cultural power. Removal of the clitoris is often cited as a means of discouraging promiscuity, as it eliminates the motivating factor of sexual pleasure.[ Citation needed ] Feminists and human rights activists disapprove of this practice because it presupposes that women lack the self control or the right to decide when and with whom they engage in sexual activity.
Aesthetic reasons are also cited. Some societies believe that FGC enhances beauty. This stems from their belief that male foreskin is removed for aesthetic reasons, and that the clitoris thus should be removed for the same reason since it is the counterpart to the penis. FGC is believed to prolong sexual pleasure of men, because it is believed that the clitoris increases sexual stimulation. [ Citation needed ]
There are no scientific or medical studies that support any of these viewpoints. While there is a correlation between FGC prevalence and religions like Islam and Christianity, prevalence rates vary by culture. These variances preclude an unequivocal link between religion and FGC. However there is debate as to whether or not FGC constitutes a religious practice in particular religious sub-cultures. 
Among practicing cultures, FGC is most commonly performed between the ages of four and eight, but can take place at any age from infancy to adolescence.[ Citation needed ] Prohibition has led to FGC going underground, at times with people who have had no medical training performing the cutting without anesthetic, sterilization, or the use of proper medical instruments. The procedure, when performed without any anesthetic, can lead to death through shock from immense pain or excessive bleeding. The failure to use sterile medical instruments may lead to infections.
Other serious long term health effects are also common. These include urinary and reproductive tract infections, caused by obstructed flow of urine and menstrual blood, various forms of scarring and infertility. The first time having sexual intercourse will often be extremely painful, and infibulated women will need the labia majora to be opened, to allow their husband access to the vagina. This second cut, sometimes performed by the husband with a knife, can cause other complications to arise.
A June 2006 study by the WHO has cast doubt on the safety of genital cutting of any kind. This study was conducted on a cohort of 28,393 women attending delivery wards at 28 obstetric centers in areas of Burkina Faso, Ghana, Nigeria, Kenya, Senegal and The Sudan. A high proportion of these mothers had undergone FGC. According to the WHO criteria, all types of FGC were found to pose an increased risk of death to the baby (15% for Type I, 32% for Type II, and 55% for Type III). Mothers with FGC Type III were also found to be 30% more at risk for cesarean sections and had a 70% increase in postpartum hemorrhage compared to women without FGC. Estimating from these results, and doing a rough population estimate of mothers in Africa with FGC, an additional 10 to 20 per thousand babies in Africa die during delivery as a result of the mothers having undergone genital cutting.
In cases of repairing the damage resulting from FGC, called de-infibulation when reversing Type III FGC, this is usually carried out by a gynecologist.
The effect of FGC on a woman's sexual experience varies depending on many factors. FGC does not eliminate sexual pleasure for all women who undergo the procedure. Although sexual excitement and arousal for a woman during intercourse involves a complex series of nerve endings being activated and stimulated in and around her vagina, vulva (labia minora and majora) and clitoris, psychological response and mind-set are also important.
In the early 1980s, Hanny Lightfoot-Klein traveled throughout Sudan (where Type III is the prevalent form of FGC, ~90%) asking women who had undergone FGC how often they had experienced orgasm during intercourse. Many of the women had no idea what an orgasm was. Others interviewed (especially if the surgery excised less tissue) not only insisted that they did achieve orgasm, ranging from 90% of the time when they were young to 10% of the time once they had children, but were open to talking about their experiences. The women were able to describe in great detail exactly what an orgasm meant to them. 
A study in 2007 found that in some infibulated women, some erectile tissue fundamental to producing pleasure had not been completely excised. Defibulation of subjects revealed that a part of or the whole of the clitoris was underneath the scar of infibulation. The study found that sexual pleasure and orgasm are still possible after infibulation, and that they rely heavily on cultural influences — when mutilation is lived as a positive experience, orgasm is more likely. When FGC is experienced as traumatic, its frequency drops. The study suggested that FGC women who did not suffer from long-term health consequences and are in a good and fulfilling relationship may enjoy sex, and women who suffered from sexual dysfunction as a result of FGC have a right to sex therapy. 
A study by Anthropologist Rogaia M. Abusharaf, found that "circumcision is seen as 'the machinery which liberates the female body from its masculine properties'".
Attempts to end the practice of FGC
Despite laws forbidding the practice, FGC remains an enduring tradition in many societies and cultural groups. Political leaders have found FGC difficult to eliminate on the local level because of its cultural and sometimes political importance. For instance, prohibition by the British of the procedure among tribes in Kenya significantly strengthened the tribes' resistance to British colonial rule in the 1950s and increased support for the Mau Mau guerrilla movement.
Because the practice holds much cultural and marital significance, FGC opponents recognize that in order to end the practice it is necessary to work closely with local communities.
Despite the close tie between FGC and cultural and, sometimes, religious tradition, there are cases where attempts at ending FGC have been successful. One example is in Senegal, where initiative was taken by native women working at the local level in connection with the Tostan Project. Since 1997, 1,271 villages (600,000 people), some 12% of the practicing population in Senegal, have voluntarily given up FGC and are also working to end early and forced marriage. This has come about through the voluntary efforts of locals carrying the message out to other villages within their marriage networks in a self-replicating process. By 2003, 563 villages had participated in public declarations, and the number continues to rise. By then, at least 23 villages in Burkina Faso had also held such community wide ceremonies, marking "the first public declaration to end FGC outside of Senegal and showing the replicability of the Tostan program for large-scale abandonment of this practice". Molly Melching of TOSTAN believes that in Senegal the practice of female genital mutilation could be ended within 2–5 years. She credits education, instead of cultural imperialism, for the rapid and significant changes which have occurred in Senegal.[ Citation needed ]
Some countries which have prohibited FGC still experience the practice in secrecy. In many cases, the enforcement of this prohibition is a low priority for governments. Other countries have tried to educate practitioners in order to make it easier and safer, instead of outlawing the practice entirely. However, with pressure from the WHO and other groups, laws are being passed in regards to FGC. On June 28, 2007 Egypt banned female genital cutting after the death of 12-year old Badour Shaker during a genital circumcision. The Guardian of Britain reported that her death "sparked widespread condemnation" of the practice. However, Britain has had its own problem confronting cases of FGC, as immigrants from Africa have been known to send their daughters to their home nations to undergo the procedure before returning to Britain.[ Citation needed ]
Laws and prevalence
The following laws are commonly cited in making a legal arguments against FGM:
- The Universal Declaration of Human Rights (1948).
- African [Banjul] Charter on Human and Peoples' Rights (1982).
- The UN Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW) (1981).
- Convention on the Rights of the Child (December 1989).
- Declaration on the Elimination of Violence against Women (1993).
- World Health Assembly resolution (WHA61.16) on the elimination of FGM (2008).
The countries where FGC is commonly practiced were identified by the US State Department.
- Burkina Faso (71.6% prevalence, Type II)
- A law prohibiting FGC was enacted in 1996 and went into effect in February 1997. Even before this law, however, a presidential decree had set up the National Committee against excision and imposed fines on people guilty of excising girls and women. The new law includes stricter punishment. Several women excising girls have been handed prison sentences. 
- Central African Republic (43.4% prevalence, Type I and II)
- In 1996, the President issued an Ordinance prohibiting FGC throughout the country. It has the force of national law. Any violation of the Ordinance is punishable by imprisonment of from one month and one day to two years and a fine of 5,100 to 100,000 francs (approximately US$8-160). No arrests are known to have been made under the law. 
- Côte d'Ivoire ( 44.5% prevalence, Type II)
- A December 18, 1998 law provides that harm to the integrity of the genital organ of a woman by complete or partial removal, excision, desensitization or by any other procedure will, if harmful to a women's health, be punishable by imprisonment of one to five years and a fine of 360,000 to two million CFA Francs (approximately US$576-3,200). The penalty is five to twenty years incarceration if a death occurrs during the procedure and up to five years' prohibition of medical practice, if this procedure is carried out by a doctor. 
- Djibouti (90-98% prevalence, Type II)
- FGC was outlawed in the country's revised Penal Code that went into effect in April 1995. Article 333 of the Penal Code provides that persons found guilty of this practice will face a five year prison term and a fine of one million Djibouti francs (approximately US$5,600). 
- Egypt (78-97% prevalence, Type I, II and III)
- Egypt's Ministry of Health and Population has banned all forms of female genital cutting since 2007. The ministry's ban order declared it is 'prohibited for any doctors, nurses, or any other person to carry out any cut of, flattening or modification of any natural part of the female reproductive system'. Islamic authorities in the nation also stressed that Islam opposes female circumcision.[ Citation needed ] The June 2007 Ministry ban eliminated a loophole that allowed girls to undergo the procedure for health reasons. There had previously been provisions under the Penal Code involving "wounding" and "intentional infliction of harm leading to death," as well as a ministerial decree prohibiting FGC. In December 1997, the Court of Cassation (Egypt's highest appeals court) upheld a government banning of the practice providing that those who did not comply would be subjected to criminal and administrative punishments. This law had proved ineffective and in a survey in 2000, a study found that 97% of the country's population still practiced FGC. In light of the widespread practice of FGC, even after the ban in 1997, some Egyptian villages decided to voluntarily give up the practice, as was the case with Abou Shawareb, which vowed in July of 2005 to end the practice. However, it remains a culturally accepted practice, and a 2005 study found that over 95% of Egyptian women have undergone some form of FGC. 
- Eritrea (90-95% prevalence, Type I, II and III)
- Eritrea has outlawed all forms of female genital cutting since 2007.
- Ghana (9-15% prevalence, Type I,II and III)
- In 1989, the head of the government of Ghana, President Rawlings, issued a formal declaration against FGC. Article 39 of Ghana's Constitution also provides in part that traditional practices that are injurious to a person's health and well being are abolished. 
- Guinea (98.6% prevalence, Type I, II and III)
- FGC is illegal in Guinea under Article 265 of the Penal Code. The punishment is hard labor for life and if death results within 40 days after the crime, the perpetrator will be sentenced to death. No cases regarding the practice under the law have ever been brought to trial. Article 6 of the Guinean Constitution, which outlaws cruel and inhumane treatment, could be interpreted to include these practices, should a case be brought to the Supreme Court. A member of the Guinean Supreme Court is working with a local NGO on inserting a clause into the Guinean Constitution specifically prohibiting these practices. 
- Indonesia (No national prevalence figures avail., Type I and IV)
- Officials are preparing to release a decree banning doctors and paramedics from performing FGC. FGC is still carried out extensively in Indonesia, the worlds largest Muslim nation. Azrul Azwar, The director general of community health, stated that, "All government health facilities will also be instructed to spread information about the decision as well as the redundancy of female circumcision." 
- Nigeria (25.1% prevalence, Type I, II and III)
- There is no federal law banning the practice of FGC in Nigeria. Opponents of these practices rely on Section 34(1)(a) of the 1999 Constitution of the Federal Republic of Nigeria that states "no person shall be subjected to torture or inhuman or degrading treatment" as the basis for banning the practice nationwide. A member of the House of Representatives has drafted a bill, not yet in committee, to outlaw this practice. 
- Senegal (5-20% prevalence, Type II and III)
- A law that was passed in January 1999 makes FGC illegal in Senegal. President Diouf had appealed for an end to this practice and for legislation outlawing it. The law modifies the Penal Code to make this practice a criminal act, punishable by a sentence of one to five years in prison. A spokesperson for the human rights group RADDHO (The African Assembly for the Defense of Human Rights) noted in the local press that "Adopting the law is not the end, as it will still need to be effectively enforced for women to benefit from it." 
- Somalia (90-98% prevalence, Type I and III)
- There is no national law specifically prohibiting FGC in Somalia. There are provisions of the Penal Code of the former government covering "hurt", "grievous hurt" and "very grievous hurt" that might apply. In November 1999, the Parliament of the Puntland administration unanimously approved legislation making the practice illegal. There is no evidence, however, that this law is being enforced. 
- Sudan (91% prevalence, Type I,II and III)
- Currently there is no law forbidding FGC, although Sudan was the first country to outlaw it in 1946, under the British. Type III was prohibited under the 1925 Penal Code, with less severe forms allowed. Outreach groups have been trying to eradicate the practice for 50 years, working with NGO's, religious groups, the government, the media and medical practitioners. Arrests have been made but no further action seems to have taken place. 
- Tanzania (17.6% prevalence, Type II and III)
- Section 169A of the Sexual Offences Special Provisions Act of 1998 prohibits FGC. Punishment is imprisonment of from five to fifteen years or a fine not exceeding 300,000 shillings (approximately US $380) or both. There have been some arrests under this legislation, but no reports of prosecutions yet. 
- Togo (12% prevalence, Type II)
- On October 30, 1998, the National Assembly unanimously voted to outlaw the practice of FGC. Penalties under the law can include a prison term of two months to ten years and a fine of 100,000 francs to one million francs (approximately US $160 to 1,600). A person who had knowledge that the procedure was going to take place and failed to inform public authorities can be punished with one month to one year imprisonment or a fine of from 20,000 to 500,000 francs (approximately US $32 to 800).
- Uganda (<5% prevalence, Type I and II)
- Female circumcision was outlawed in Uganda in 2009. Those convicted of the practice receive 10 years in jail. It is said to still be practiced by the Sabiny, some Karamojong sub-groups and the Pokot in eastern Uganda, as well as the Nubi people of West Nile.
- World Health Organization. (2010, February). WHO Female Genital Mutilation. Retrieved August 4, 2010, from World Health Organization: http://www.who.int/mediacentre/factsheets/fs241/en/
- Charlotte Feldman-Jacobs. "Commemorating International Day of Zero Tolerance to Female Genital Mutilation". http://www.prb.org/Articles/2009/fgmc.aspx.
- Morison, Linda (2001), The long-term reproductive health consequences of female genital cutting in rural Gambia: a community-based survey, Tropical Medicine and International Health, 6(8),643-653.
- Cook, Rebecca J.; Bernard M. Dickens, Mahmoud F. Fathalla (2003). Reproductive Health and Human Rights: Integrating Medicine, Ethics, and law. Oxford University Press. p. 262. ISBN 0199241333.
- Shell-Duncan, Bettina (April 2001). "The medicalization of female "circumcision":harm reduction or promotion of a dangerous practice?". Social Science & Medicine 52 (7): 1013–1028. doi:10.1016/S0277-9536(00)00208-2.
- Toubia, N (1995). "Female Genital Mutilation". in Peters, J; Wolper, A. Women's Rights, Human Rights: International Feminist Perspectives. New York: Routledge. p. 226. ISBN 0415909953.
- World Health Organization. (1996). Female genital mutilation: Report of a WHO Technical Working Group (unpublished document WHO/FRH/WHD/96.10). Geneva: World Health Organization. Retrieved 2007-02-21.
- Obermeyer, Carla Makhlouf (March 1999). "Female Genital Surgeries: The Known, the Unknown, and the Unknowable". Medical Anthropology Quarterly 13 (1): 79–106. doi:10.1525/maq.19184.108.40.206. PMID 10322603. http://links.jstor.org/sici?sici=0745-5194%28199903%292%3A13%3A1%3C79%3AFGSTKT%3E2.0.CO%3B2-3. Retrieved 2007-11-19.
- Alexia Lewnes (Ed) (2005). "Changing a Harmful Social Convention: Female Genital Mutilation/Cutting" (pdf). Innocenti Digest. UNICEF. pp. 1–2. ISBN 88-89129-24-7 1028-3528. http://www.unicef-irc.org/publications/pdf/fgm_eng.pdf. Retrieved 2006-09-09.
- United Nations. (1996, March). 96-03: Dispatches -- News from UNFPA, No. 6, March 1996. Retrieved August 4, 2010, from UN: http://www.un.org/popin/unfpa/dispatches/mar96.html
- Eliminating Female Genital Mutilation – An interagency statement OHCHR, UNAIDS, UNDP, UNECA, UNESCO, UNFPA, UNHCR, UNICEF, UNIFEM, WHO. Department of Reproductive Health and Research (RHR), World Health Organization. 2008.
- S Elmusharaf; N Elhadi, L Almroth (2006-07-15). "Reliability of self reported form of female genital mutilation and WHO classification: cross sectional study". BMJ 333 (7559): 124. doi:10.1136/bmj.38873.649074.55. PMID 16803943.
- Cormier, Zoe (fall 2005). "Making the Cut". Shameless. http://shamelessmag.com/issues/2005/fall/making-cut/. Retrieved 2008-03-03.
- "Female genital mutilation". World Health Organization. June 2000. http://www.who.int/mediacentre/factsheets/fs241/en/index.html. Retrieved 2008-01-23.
- Pieters, Guy, M.D.; Albert B. Lowenfels, M.D., F.A.C.S. (April 1977). "Infibulation in the Horn of Africa". New York State Journal of Medicine 77 (6): 729–731. http://www.cirp.org/pages/female/pieters1.
- Lightfoot-Klein, Hanny, M.A. (August 1989). "The Sexual Experience and Marital Adjustment of Genitally Circumcised and Infibulated Females in The Sudan". The Journal of Sex Research (The Society for the Scientific Study of Sexuality) 26 (3): 375–392. doi:10.1080/00224498909551521. http://www.fgmnetwork.org/authors/Lightfoot-klein/sexualexperience.htm.
- "Egypt forbids female circumcision". BBC News. 2007-06-28. http://news.bbc.co.uk/1/hi/world/middle_east/6251426.stm. Retrieved 2010-05-02.
- "Female genital mutilation in Iraqi Kurdistan. Presented at the 1ère Journée Humanitaire sur la Santé des Femmes dans le Monde, Paris, France". Gynécologie sans Frontières. 27.03.2006. http://www.stopfgmkurdistan.org/html/english/updates/update003e.htm.
- Birch, Nicholas (August 10, 2005). "Female circumcision surfaces in Iraq". The Christian Science Monitor. http://www.csmonitor.com/2005/0810/p06s01-woiq.html?s=t5. Retrieved 2006-10-02.
- International Campaign for the Abandonment of FGM/C. (2010). A Testimony on Female Genital Mutilation in India. Retrieved August 4, 2010, from STOP FGM/C!: http://www.stopfgmc.org/client/sheet.aspx?root=168&sheet=1951&amp;amp;amp;amp;amp;amp;amp;amp;amp;lang=en-US.
- US Department of State (June 1, 2001). "Indonesia: Report on Female Genital Mutilation (FGM) or Female Genital Cutting (FGC)". Press release. http://www.state.gov/g/wi/rls/rep/crfgm/10102.htm. Retrieved 2006-10-02.
- Skaine, R (2005). Female genital mutilation: Legal, cultural and medical issues. Jefferson, North Carolina, USA: McFarland. ISBN 0-7864-2167-3.
- Paige, Karen Ericksen (May 1978). "The Ritual of Circumcision". Human Nature: 40–48. http://www.noharmm.org/paige.htm.
- Post, S., (2004). Encyclopedia of Bioethics. New York: Macmillan Reference USA.
- Obermeyer, Carla Makhlouf (March 1999). Female Genital Surgeries: The Known, the Unknown, and the Unknowable. 13. pp. 79–106. http://links.jstor.org/sici?sici=0745-5194%28199903%292%3A13%3A1%3C79%3AFGSTKT%3E2.0.CO%3B2-3. Retrieved 2007-12-01.
- Komisaruk, B. et al.: The Science of Orgasm. JHU Press, 2006. For an interview with two of the researchers, see "Exploring the Mind-Body Orgasm", http://www.wired.com/medtech/health/news/2007/01/72325
- Mah K, Binik YM: "Are orgasms in the mind of the body? Psychosocial versus physiological correlates of orgasmic pleasure and satisfaction". Journal of Sex and Marital Therapy 31:187–200, 2005.
- Lightfoot-Klein, Hanny (1989). "The Sexual Experience and Marital Adjustment of Genitally Circumcised and Infibulated Females in The Sudan". The Journal of Sex Research 26 (3): 375–392. http://www.fgmnetwork.org/authors/Lightfoot-klein/sexualexperience.htm. See also Prisoners of Ritual: An Odyssey into Female Genital Circumcision in Africa, by Hanny Lightfoot-Klein; Harrington Park Press, 1989, ISBN 0-918393-68-X
- Catania, Lucrezia; Omar Abdulcadir, Vincenzo Puppo, Jole Baldaro Verde, Jasmine Abdulcadir, Dalmar Abdulcadir (November 2007). "Pleasure and Orgasm in Women with Female Genital Mutilation/Cutting (FGM/C)". The Journal of Sexual Medicine 4 (6): 1666–1678. doi:10.1111/j.1743-6109.2007.00620.x. PMID 17970975.
- Abusharaf, Rogaia M. (2001). "Virtuous Cuts: Female Genital Circumcision in an African Ontology". Differences: A Journal of Feminist Cultural Studies 12: 112–140. doi:10.1215/10407391-12-1-112.
- Birch/Abril, Nicholas (2008-01-04). "An End to Female Genital Cutting?". Time Magazine. http://www.time.com/time/world/article/0,8599,1700191,00.html. Retrieved 2008-01-08.
- Birch/Abril, Nicholas. "An End to Female Genital Cutting?", Time magazine, 2008-01-04. Retrieved on 2008-01-08.
- TOSTAN (May 18, 2005). "Ending Female Genital Cutting In Dialacoto – A Celebration Of Life And Culture". Press release. http://www.tostan.org/news-sept_21_03.htm. Retrieved 2006-10-02.
- TOSTAN. (2007). Abandoning Female Genital Cutting. Retrieved August 5, 2010, from TOSTAN: http://tostan.org/web/page/586/sectionid/547/parentid/585/pagelevel/3/interior.asp
- "Death of 12-Year-Old Circumcised Girl Shocks Egypt, Prompts Ban on Rite". Associated Press. 2007-06-27. http://www.foxnews.com/story/0,2933,287393,00.html. Retrieved 2008-01-11.
- Circumcision Information Resource Pages. (2003, October 1). Female Genital Mutilation. Retrieved August 5, 2010, from Circumcision Information Resource Pages: http://www.cirp.org/pages/female/
- US Department of State. (2001, June 1). FGM Individual Country Reports. Retrieved August 5, 2010, from US Department of State: http://web.archive.org/web/20080306114419/http://www.state.gov/g/wi/rls/rep/crfgm/
- Stolz, Joëlle (September 1998). "Le Burkina Faso fait reculer l'excision" (in French). Le Monde diplomatique: pp. 18. http://www.monde-diplomatique.fr/1998/09/STOLZ/10970. Retrieved 2006-10-02.
- "Egypt strengthens ban on female genital cutting". Reuters. 2007-06-28. http://www.reuters.com/article/healthNews/idUSL2801275920070628?feedType=RSS. Retrieved 2008-01-11.
- Reuters. (2007, August 20). Egypt Death Sparks Debate on Female Circumcision. Retrieved August 5, 2010, from Reuters: http://www.reuters.com/article/idUSL30168862
- BBC News. (2007, April 4). Eritrea Bans Female Circumcision. Retrieved August 5, 2010, from BBC News: http://news.bbc.co.uk/2/hi/africa/6527619.stm
- "Indonesia to ban female circumcision". Stop FGM. June 2, 2005. http://www.cbc.ca/world/story/2005/06/02/circumcision050602.html. Retrieved 2006-10-02.
- BBC News. (2009, December 10). Uganda Bans Female Genital Mutilation. Retrieved August 5, 2010, from BBC News: http://news.bbc.co.uk/2/hi/africa/8406940.stm.