Excision: summer holidays, a risky period for adolescent girls

During the summer holidays, many young girls residing in France will make the trip to their parents' country of origin. If excision is practiced there, there is a risk for them of undergoing this cultural sexual mutilation.

CThis is why a national prevention campaign, launched by the association Excision parlons-en, encourages them to get information and, if necessary, to ask for help. "Be suspicious and courageous, maybe not the trip of your dreams, you must not fall in the trap" sings the interpreter of the animated clip with the evocative title: "You thought to go on vacation? "

The association's website alert-excision.org presents a map of the world listing the countries where excision is practiced. "In France, we think that we are not concerned, but there are women circumcised among our neighbors, the comrades of our children, our colleagues", explained Moira Sauvage, the president, on the occasion of the campaign launch. She estimates the number of excised women living on French territory at around 60.

The fight against excision has been erected as a symbol of human rights mainly through the decade of the United Nations (UN) which was dedicated to women from 1975 to 1985. The strategies to combat this female genital mutilation have varied over time, with mixed success. One of the essential conditions for their success is a good knowledge of the practices, described in detail in my book Between faith, laws and rights, the experience of excision in texts and contexts, published in 2016 by L'Harmattan editions.

Excision entered the classification of “female genital mutilation” (FGM) in the 1990s through organizations such as the World Health Organization (WHO), UNICEF, the United Nations Fund. for the population (UNFPA) and the International Federation of Gynecology and Obstetrics (FIGO). At the time, these organizations made a “joint declaration” against this scourge.

Removal of the clitoris and labia minora

The campaign of the Excision association let's talk about it in the streets of Paris this year.Association Excision let's talk about it

Genital mutilation is classified into four types by the WHO, of which the first three are the most common. Type I, or sunnah, is the partial or total removal of the clitoris and / or the foreskin or hood of the clitoris (clitoridectomy). Type II, or excision, consists of the partial or total removal of the clitoris and the labia minora (labiadectomy), with or without excision of the labia majora.

Type III, infibulation, consists of narrowing the vaginal opening by covering the vulva by the ablation, then the joining (suture) of the labia minora and / or the labia majora, with or without excision of the clitoris. The urethra and vaginal introitus are covered, leaving only a small opening - up to the size of a grain of rice - for urine and menstrual flow.

Excision of the clitoris has long been called "female circumcision" as a counterpart to male circumcision. In Kikuyu in Kenya, theirua moreover designates the two practices. These were equivalent in most African cultures: the clitoris was considered to be a male vestige that had to be shed for the girl to gain femininity, and the foreskin of the penis a female vestigial organ that had to be cut so that the boy accesses masculinity.

A practice that preceded the three great religions

This ancestral practice dates from before the advent of the three great monotheistic religions - Judaism, Christianity and Islam. The term sunnah which falls under type I, refers to an attenuated excision (compared to the more severe pre-Islamic form) recommended by Mohamed to an exciser, in a Hadith(an oral communication from the prophet). In the Muslim religion, excision is therefore makrumah, that is, translated from Arabic, desirable or recommended, but not required (mandatory).

Excision is practiced mainly in Africa, although it is also de rigueur elsewhere, such as in Indonesia. Let us not forget that it was also a custom in Europe, where it functioned as a measure against masturbation in young girls until the beginning of the twentieth century. An American, Renee Bergstrom, testified recently having suffered it for this reason in 1947, at the age of three. In Africa, the practice is distributed along two axes, east-west and north-south, corresponding approximately to the roads of slavery, which crossed in Sudan. It is therefore prevalent in Sierra Leone, Guinea, Mali, Somalia, Djibouti and Eritrea, where it reaches 90% of the female population.

A woman and her baby, Sierra Leone.Annie Spratt / Unsplash

These genital alterations, performed with unsterilized knives or razors, needles or acacia thorns, cause trauma whose effects last. They can cause serious health problems, such as tetanus, sepsis, blood loss, urinary retention, cysts, damage and inflammation of the genitals and adjoining organs, as well as infertility, sexual dysfunction, and sometimes death by hemorrhage.

To limit these risks, the practice in some countries has been medicalized, carried out in particular in a hospital environment. But this security has the drawback, in the eyes of some, to legitimize the practice.

Control of the girl's sexual appetites

Excision is justified in various ways. The motives can be socio-cultural, aiming at controlling the sexual appetites of the young girl and at guaranteeing her virginity when offered in marriage. They can be of the order of purification, hygiene and genital "beauty" - the "silky" appearance of the scarred vulva is evoked for infibulation. Finally, the reasons can be religious and patriarchal. In fact, excision once served as a chastity belt and today confines a woman's sexuality to reproduction.

To counter this practice, one of the least productive approaches has been penalization. Bobigny's lawsuits in the 1980s against the Bambara and Soninké families living in Paris showed its limits, as described in the book Excision on trial, a cultural dispute (The Harmattan). The defense of the integrity of the body from a Christian perspective and the Western rejection of a non-Western practice have not been more effective.

The most productive approach remains that which emphasizes the well-being and health of the child, young girl and circumcised woman. They were at least 200 million in the world in 2016, according to Unicef, to have undergone a variant of the practice.

Alternative rites of passage for adolescent girls have also been proposed, such as excision by words (instead of evils), retirement from society or a diploma awarded to the young girl.

The abandonment of the practice by Senegalese excisors

Another effective eradication strategy is public education. It consists in raising the awareness of parents, men - alleged beneficiaries of these practices - and women specialized in this ritual, the excisors. In Senegal, in 1997, Bambara excisors from the Malicounda community abandoned their “tools” en masse, under the aegis of the national Tostan program (“breakthrough” in Wolof). They revived the indigenous tradition of taking the oath, replacing excision, and put pressure on the Senegalese government, which then condemned the ritual.

It is important that the external interveners combine their efforts with the actors in the field who are the excisors in order to avoid the phenomenon of reactance, this defense mechanism implemented by an individual who tries to maintain his freedom of action when believes it to be removed or threatened. Otherwise the efforts were in vain, as was the case in Sudan in 1946. British colonists decreed infibulation illegal, which resulted in the practice being clandestinely survived.

Without being able to prevent excision, surgical repair can reduce the consequences. French urologist Pierre Foldès, who discovered excision during a trip to Burkina Faso in the 80s, practice of such inverventions in his office in Saint-Germain-en-Laye (Yvelines).

A subject of humor in Great Britain

Excision is now known to the general public and some countries such as Great Britain do not hesitate to seize the phenomenon. In 2004, we could see during an episode of the very popular comedy television series Nip / Tuck a surgeon making love with a patient who had just undergone reconstruction of the clitoris, in order to check whether the operation was successful or not.

More seriously, at the beginning of this year, the British channel BBC1 broadcast a drama series by Heidi Thomas, Call the Midwife (Call the midwife). One of the episodes shows the confrontation between Somali women infibulated and British nurses unaware of this practice.

The ConversationWhile excision has lost ground, its decline remains relatively slow and varied from state to state. Globally, it is still far from being eradicated, as shown by a report published by INED in April. In France, informing adolescent girls and encouraging them to dial 119 (the number for children in danger) can improve the situation.

Chantal Zabus, University professor, member of the Institut Universitaire de France (IUF), Paris 13 University - USPC

La original version of this article was posted on The Conversation.

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