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PubMed1996

Female circumcision in southern Chad: origins, meaning, and current practice.

Female circumcision is widely practiced on the African continent; however, published reports describing genital operations on women in non-Islamic, sub-Saharan societies are scarce. This paper examines female circumcision as it is practiced by the Sara, one of Chad's largest ethnic groups. For the Sara, circumcision is an integral part of the female initiation ceremony, the rite of passage marking the transition from childhood to adulthood. Through in-depth interviews and archival research, we trace the origins of female circumcision among this group and examine its role and function in the context of contemporary Sara culture. Urban women's attitudes and practices regarding circumcision are also examined via household surveys. The data indicate that female circumcision has been recently incorporated into the Sara's cultural repertoire, and suggest strategies to reduce its incidence in this setting.

Adolescent↗
PubMed1997

Female circumcision: implications for North American nurses.

1. Female circumcision is a centuries-old tradition that continues today and directly involves nursing practice and care of these patients. 2. Aside from traditional rites, female circumcision may be performed for economic factors, sexual control, and beliefs of its positive effects on childbirth. 3. Laws in North America and Europe ban the practice, but many children are sent abroad to have female circumcision performed.

Africa↗
PubMed1995

Female circumcision.

Three cases of female circumcision are presented together with a literature review. Unfortunately, this procedure frequently results in genital mutilation. Treatment with deinfibulation enables restoration of the external genitalia and vagina. Obstetric and gynaecological complications have been documented, but emotional and psychological effects may be difficult to assess. These women should be treated without bias and with sensitivity.

Adult↗
PubMed2002

The decline of female circumcision in Egypt: evidence and interpretation.

Female circumcision is widespread in Egypt. Research suggests that the practice persists because of a belief that circumcision will moderate female sexuality, that it will assure a girl's marriagability, and that it is sanctioned by Islam. Using data from a nationally representative survey of adolescents, this paper investigates the prevalence and social correlates of circumcision among girls aged 10-19, the circumstances surrounding the procedure, and the attitudes of adolescents towards it. While the vast majority of adolescents are circumcised, a life table analysis indicates that girls today are at least 10 percentage points less likely to undergo female circumcision than were their mothers. Circumcision may have begun to decline prior to the time when the current cohort of girls were at risk; however, the data hint at a temporal association between the decline and the 1994 International Conference on Population and Development (ICPD) in Cairo, a time when the campaign against circumcision gained momentum. Over half of circumcised girls reported that the procedure was performed by a physician or nurse rather than a traditional practitioner. This represents a substantial increase over rates of "medicalized" circumcision found among earlier cohorts of Egyptian women. Even among circumcised girls, support for the practice is by no means universal, with 14 percent saying they think the procedure is unnecessary and a further 28 percent expressing ambivalence. A multivariate analysis indicates that girls who have been or are currently in school, who live in urban governorates, and who are older are more likely to believe that circumcision is not obligatory. When the analysis includes boys as well as uncircumcised girls, a large gender gap emerges, with boys considerably more supportive of the practice than are their female counterparts.

Adolescent↗
PubMed1995

Epidermal inclusion cysts of the clitoris as a complication of female circumcision and pharaonic infibulation.

Female circumcision and pharaonic infibulation is still performed on young females in many parts of the world. It is estimated that two thousand young women living in Britain undergo this ritual every year. The most common complication of this procedure is epidermal inclusion cysts within the infibulation cicatrix. We report the clinical and pathological findings in 10 cases of clitorial inclusion cysts seen at the North West Armed Forbes Hospital, Tabuk, Saudi Arabia between 1989 and 1993. The clinical diagnosis in six cases was that of "clitoral tumor". Two patients presented with complaints of localized pain, one patient presented with dyspareunia and one patient presented with the complaint of a sporadic discharge of white fluid from the circumcision scar. The pathological findings were those of an implantation dermoid in all cases except in two patients where cysts had ruptured and had become inflamed and/or infected. Four cysts were multilocular.

Adolescent↗
PubMed2003

Defective sexuality and female circumcision: the cause and the possible management.

AIM: To verify the effect of circumcision on female sexuality and to define the need for clitorolabioplasty in these cases. METHODS: Thirty uncircumcised controls, 30 minorly circumcised, 30 minorly circumcised mutilated, and 57 circumcised cases having clitoral cysts were selected on random bases at Kasr El Aini School of Medicine. Sexuality was assessed by a special questionnaire sheet prepared by the authors to fit the circumcised cases. Clitorolabioplasty and clitoral cyst excision were also done in cases of sexual defects. RESULTS: Sexuality was not affected in minorly circumcised cases. However, sexuality was markedly affected in the mutilated cases. The scores for sex desire and arousal and for orgasm were especially affected in such cases. These defects were not detected in cases having clitoral cysts until late, when cysts enlarged. The role of clitorolabioplasty in restoration of sexuality was confirmed. The loss of certain clitoral and labial bulk, necessary for orienting the woman towards her genitalia and initiating her interest in their function, was responsible for the occurrence of such defects; this was able to be restored by surgery. CONCLUSION: Counseling parents about these sexual defects and asserting the need for correcting the mutilation, which resulted from these circumcisions, are effective steps in banning such procedures.

Adolescent↗
PubMed2001

The medicalization of female "circumcision": harm reduction or promotion of a dangerous practice?

In recent decades the practice of female "circumcision" has come under intense international scrutiny, often conceptualized as a violation of women's basic right to health. Although the adverse health consequences of female "circumcision" form the basis of opposition to the practice, anti-circumcision activists, as well as many international medical associations, largely oppose measures to improve its safety. The debate over medicalization of female "circumcision" has, up until now, been cast as a moral dilemma: to protect women's health at the expense of legitimating a destructive practice? Or to hasten the elimination of a dangerous practice while allowing women to die from preventable conditions? This paper seeks to re-examine this debate by conceptualizing medicalization of female "circumcision" as a harm-reduction strategy. Harm reduction is a new paradigm in the field of public health that aims to minimize the health hazards associated with risky behaviors, such as intravenous drug use and high-risk sexual behavior, by encouraging safer alternatives, including, but not limited to abstinence. Harm reduction considers a wide range of alternatives, and promotes the alternative that is culturally acceptable and bears the least amount of harm. This paper evaluates the applicability of harm reduction principles to medical interventions for female "circumcision," and draws parallels to other harm reduction programs. In this light, arguments for opposing medicalization of female "circumcision", including the assertion that it counteracts efforts to eliminate the practice, are critically evaluated, revealing that there is not sufficient evidence to support staunch opposition to medicalization. Rather, it appears that medicalization, if implemented as a harm-reduction strategy, may be a sound and compassionate approach to improving women's health in settings where abandonment of the practice of "circumcision" is not immediately attainable.

Circumcision, Female↗
PubMed2000

Female circumcision: at our doorsteps and beyond.

Recent trends in international travel and emigration have brought the practice of female circumcision, also known as female genital mutilation, to the awareness of an increasing number of physicians and public policy agencies in developed countries. The main reason for the continuation of this practice is deeply held tradition. The high incidence of complications attending the procedure leads to a poor quality of life and potential life-threatening problems. Female circumcision serves no biologically useful purpose and perpetuates the subjugation and social deprivation of females. Suggestions for the eradication of this custom include universal education of females and public enlightenment campaigns; legislation tends to send the practice underground. This review is aimed at providing objective background information on female circumcision to residents in obstetrics and gynecology. An effective solution to this problem requires not just knowledge but also wisdom in order to offer a compassionate approach to the management of these women. The American women's health care specialist should be well informed on this issue because of the increasing likelihood of contact with these women. It is also hoped that health care providers will become sensitized to the point of designing and participating actively in effective schemes for the worldwide eradication of this practice.

Journal Article↗
PubMed1996

The cultural debate over female circumcision: the Sudanese are arguing this one out for themselves.

This article critiques medical ecological analysis of female circumcision as a "maladaptive cultural pattern" and argues that this highly controversial procedure must be analyzed within the larger contexts of women's lives in underdeveloped countries. International efforts to eradicate female circumcision, while often couched in seemingly progressive feminist rhetoric, inadvertently serve to mask the negative health effects of the economic exploitation of poor countries such as Sudan. Reproductive histories and ethnographic data are used to argue that though female circumcision is not maladaptive, cultural discourse about it is resulting in changes in the meaning, techniques, and frequency of this practice.

Adolescent↗
PubMed2005

Bodily integrity and male and female circumcision.

This paper explores the ambiguous notion of bodily integrity, focusing on male and female circumcision. In the empirical part of the study we describe and analyse the various meanings that are given to the notion of bodily integrity by people in their daily lives. In the philosophical part we distinguish (1) between a person-oriented and a body-oriented approach and (2) between four levels of interpretation, i.e. bodily integrity conceived of as a biological wholeness, an experiential wholeness, an intact wholeness, and as an inviolable wholeness. We argue that bodily integrity is a prima facie principle in its own right, closely connected with, but still fundamentally different from, the principle of personal autonomy, that is, autonomy over the body.

Circumcision, Female↗
PubMed2006

Trends in female circumcision between 1933 and 2003 in Osun and Ogun States, Nigeria (a cohort analysis).

The international movement against female circumcision gained momentum in the past two decades. Although recent studies report decline in the practice none has studied the cohort effect or provided plausible explanation for such decline. Changes in female circumcision occurring in two southwestern States of Nigeria between 1933 and 2003 were tracked in a cross-sectional survey using cohort analysis. 1174 female live births to 413 women were included in the analysis. About fifty-three percent of all females were circumcised. The prevalence dropped from 64.9% during the period 1933-60 to 25.7% for the period 2000-2003. For first order births, the corresponding rates were 58.8% and 25.0%. The decline for first-born females comes a decade before other birth orders. Age and education of mother are two main factors of the decline. Global consensus or legal enforcement plays secondary roles. Understanding how modernisation affects the decline in female circumcision should receive greater attention.

Age Factors↗
PubMed1998

Female circumcision.

The letter on unsafe male circumcision by Dr. H. Gretahun (Africa Health, March 1997) brings into very clear focus the whole issue of genital mutilation. Circumcision, whether male or female, does not per se amount to genital mutilation unless performed unsafely. Female circumcision involves only reducing the rudimentary penis, the clitoris, in order to tuck it neatly and beautifully under the labia majora. When the operation involves slicing off the labia, it ceases to be circumcision. Any scar tissue formed, both in size and location, is never enough to interfere with childbirth, otherwise the Black race would have been extinct millennia ago. Orgasm is not impeded in any way or else the female population of the planet would have been 80% frigid. If an uncircumcised female exhibits greater excitability, it is to be expected; even the constant friction between the clitoris and the underpart sets off some amount of auto-arousal. African female anti-circumcision activists should stop to consider the real issues and recognize the ulterior motives of the Western world, where even males are not circumcised. They should worry more about AIDS, which the West created as a weapon against its Communist opponents using Africans as laboratory animals. Africans should be demanding compensation and free distribution of all available drugs and not condoms.

Africa↗
PubMed1998

Female circumcision.

The practice of female genital mutilations is widespread in many developing countries, yet health care professionals typically know little about the care of circumcised women. With the influx of immigrants and refugees from developing countries into Western cultures, it's important for nurses to understand some of the customs, beliefs, and traditions surrounding female circumcision (Calder, et al., 1993; McCleary, 1994). It's estimated that approximately 2 million procedures are performed annually (WHO, 1997).

Adolescent↗
PubMed1999

Female circumcision: the prevalence and nature of the ritual in Eritrea.

This study evaluates the prevalence, complications, and attitudes concerning the practice of female circumcision among the women of Eritrea. Four hundred thirty-six Eritrean women from rural and urban environments were questioned about their perceptions and beliefs concerning female circumcision. Eighty-eight percent of those interviewed had undergone some form of female circumcision. Those who favored the continuation of the practice were more likely to be rural dwellers with little formal education, and they did so primarily out of tradition or cultural conformity. The direct and indirect consequences of this practice to the health of women and infants are considerable and as complex as the social, religious, and traditional factors that have led to its preservation.

Adult↗
PubMed2004

Infertility from female circumcision.

OBJECTIVE: To present a case report of a patient with primary infertility from female circumcision, the management of the patient, and a review of the literature. DESIGN: Case report and literature review. SETTING: University hospital. PATIENT(S): A 31-year-old woman referred for a history of primary infertility. INTERVENTION(S): Complete history and physical exam of the patient and subsequent deinfibulation. MAIN OUTCOME MEASURE(S): Diagnosis, surgical management, and postoperative sexual function and pregnancy. RESULT(S): Resolution of dyspareunia, satisfactory postoperative sexual function, and pregnancy. CONCLUSION(S): Awareness of this type of female circumcision and familiarity with its surgical management may prevent delays and any subsequent complications.

Adult↗
PubMed1997

Female circumcision: an emerging concern in college healthcare.

Female circumcision (clitoridectomy), a traditional practice in some Third World societies, is discussed, and related medical procedures are described. Medical and psychosexual implications for the patient are considered, and college health clinicians are encouraged to be prepared to see patients who have been subjected to the procedure and help these young women deal with attendant medical, emotional, and cultural issues. One female student's experience at her college health service is described.

Adult↗
PubMed1991

Female circumcision. Should angels fear to tread?

Female circumcision has been banned in this country since 1985. But is statutory intervention an appropriate way to tackle an issue so highly charged with complex taboos of race, culture and sexuality? Are we talking about a religious rite--or about child abuse?

Child↗