Thursday, July 5, 2007

Problematizing Legal Approaches Toward Stopping FGS

On Pandagon, Amanda relates what she calls some good news: Egypt has outlawed FGM.

From the article:

Officially the practice, which affects both Muslim and Christian women in Egypt and goes back to the time of the pharoahs, was banned in 1997 but doctors were allowed to operate "in exceptional cases".

On Thursday, Health Minister Hatem al-Gabali decided to ban every doctor and member of the medical profession, in public or private establishments, from carrying out a clitoridectomy, a ministry press official told AFP.

On the Pandagon thread, a commenter called Dan writes: "Obviously, banning FGM is always a step in the right direction..."

I am not convinced that this is obvious. Nor am I necessarily convinced that this outcome is good news.

Some Background
One thing that one learns in the study of anthropology is that culture is a holistic entity. That means that you can't split it up into tiny bits and interact with those bits piece by piece. You can't hold up -- say -- dowry burnings and say "this is what dowry burning is, this is what it means" outside the context of the rest of the culture, anymore than you could hold up "I Love Lucy" to people who didn't understand Western gender roles or Western materialism or a Western sense of humor and expect them to understand it.

Female genital surgeries (FGS) are the same way; they exist within a cultural context that gives them meaning. The cultural contexts are different, so the meanings are different.

Let me take a brief digression to deal with the issue of terminology. I'm going to call the procedures FGS, which is the term that an anthropologist friend of mine favors when he teaches Intro to Anth. FGS is not a perfect term. However, it is an attempt to ameliorate some of the problems with other terms. Female genital mutilation (FGM) is a term that many African women, and others, object to as stifling conversation because the term itself is alienating and inflammatory. Female circumcision is inaccurate, and leads to a false equivalency between male and female circumcision since it creates an ersatz linguistic link between the two procedures.* FGS is an attempt at a middle ground.

Female genital surgeries exist in many different forms, in many different cultural contexts. Here are some of the physical manifestations of the surgery:

  • Nicking of the clitoris or removing the tip of the clitoris - relatively unusual

  • Clitorodectomy - the most common form of FGS, involving removal of the clitoris. Often practiced along with the removal of the labia minora. May or may not be accompanied by a procedure intended to kill the clitoral nerve, such as pressing hot needles into the affected area.

  • Infibulation - the removal of the clitoris, labia minora, and labia majora. The inner walls of the vagina are scraped and then sewn together, leaving a hole as small as a woman's pinky finger. This procedure can make menstruation and urination very difficult and lead to an increased probability of health complications like uterine prolapse. Tough, inelastic scar tissue is unyielding, making birth a dangerous process. Infibulated women must be cut open for sex and birth, and are often resewn afterward.

FGS are also done for a variety of reasons. Each culture that practices FGS will be practicing its own variation -- in terms of what the surgery consists of, and why it is done. For this reason, it's very difficult to talk about FGS as a monolith. And there's a good reason for that. FGS are not a monolith.

For instance, it's not uncommon to encounter feminists arguing that FGM is done to eliminate female sexual pleasure, or to prevent women from cheating. FGS are not done solely for either of these reasons, although they are some of the reasons stated by some cultures.

For the Kikuyu in Kenya, who practice clitorodectomy, FGS is practiced as a rite of passage in order to create a more visible separation between men and women. The clitoris, or masculine part, is removed to make the woman more womanly (conversely, the foreskin which is seen as being like the labia, is removed to make men more manly). Therefore, any attempts to eliminate FGS among the Kikuyu will have to react to these cultural motivations.

It would be inappropriate for the same solutions to be attempted among the Kikuyu as would be used in infibulation-practicing East African countries like Ethiopia and Somalia, countries that are very patriarchal and have clear interests in establishing inheritance laws. Unlike the FGS practiced by the Kikuyu, Ethiopian and Somalian infibulation appears to arise from an interest in protecting paternity rights (Carolyn Martin Shaw). They want to make sure that inheritance goes to genetic sons. Women - often upper-class women - bear the brunt of this (as they did in Europe with chastity belts, in the middle east with seclusion, in China with footbinding) because the patriarchy (supported by both men and women) views them as vessels for heirs. Reducing their ability to become pregnant by men who are not their husbands makes it more likely that inheritance will go to genetic heirs. Cultural practices grow around this desire. Later, these practices are fetishized.

Clitorodectomy and infibulation are both practiced by some cultures that believe the touch of a woman's uncircumcized genitals will sap a man of his ability to hold an erection, cause hydrocephally, and/or kill any infant the woman bears. This myth is enduring. You may think that decades of interaction with white women who are uncircumcized and yet able to bear children would have shaken the myth, but this is often not the case. White women often choose not to bear children or to bear very few children, which means that white women are often seen as infertile. Thus it is possible for African women from FGS-practicing cultures to interact with uncircumcized white women and still believe that circumcision is necessary for fertility.

The point of all this is: FGS is not something that exists in isolation. It exists for particular reasons. You don't get rid of those reasons by changing the law. All you do is create a situation in which the reasons still exist (need for a rite of passage, to ensure paternity, to ensure fertility), but the traditional method of meeting those needs has been outlawed.

Laws Against FGS Analogized to Laws Against Rape

On a Feministe thread about the ban, Jill writes in defense of the law. "I don’t think anyone is saying FGM is going to disappear," she writes, acknowledging that the ban will not be a cure. She goes on to say, "But it is important that they’ve outlawed it, since that reflects a profound social shift, and it allows people to be prosecuted for it... Rape laws don’t get rid of rape, but I’d rather have them than not."

I think Jill is erring in comparing FGS to rape. FGS is a culturally sanctioned, overt part of how the society functions. Rape is at best a covert part of our cultural function. While it holds up patriarchy by limiting women's movements, it also subverts patriarchy because it is a threat to paternal property. FGS is not like that.

In my opinion, a better analogy would be to compare FGS to - say -- capture marriage as its practiced in Nepal, in which a young man kidnaps a young woman and marries her by force. To western eyes, these marriages look superficially abhorrent (and they're certainly not 100% good). But we're missing the subtleties of the capture marriages. These marriages are often arranged before hand and approved by both families as a way of allowing a young couple to marry when they do not have the financial resources to put on a huge wedding. In many (I think most) capture marriages, the woman is not actually in danger, or experiencing surprise; she feigns both ritualistically. However, the bride is not always told of the capture marriage beforehand. Capture marriages are a culturally sanctioned process which serves particular culturally sanctioned purposes (allowing a way for the children of families who have fallen on hard times to marry), and which puts the interest of families above the interests of the woman.

It would be possible to make laws against capture marriage, in ostensible defense of the woman's independence. However, the kinds of laws that tend to get enacted in situations like these are made with a western gaze. We see the surface effect of a capture marriage and apply it to known situations -- the biblical Sabine women, for instance. We aren't looking at the reasons why capture marriages exist, or how they are rooted in the culture. Addressing the symptom by making capture marriages illegal may actually make the situation worse for women.

And this is what we have seen, time and time again, with regard to legal remedy for FGS.

A Brief Overview of Some Historical Consequences of Outlawing FGS

Missionaries who got down to Africa really didn't like FGS. Well, I don't either. Many of them did what seems like the logical thing to do when you are in ostensible control of a group of people who are doing something that you think is a major violation of human rights, moral decency, and God's law. They decided to ban it.

Early bans had a number of consequences (not all of which occurred in all places).

  • Circumcision began to be performed on younger and younger girls. Because it was less likely that missionaries or western colonial agents would be messing in the lives of infant or very young girls, and because infants and very young girls would be less likely to understand what was going on well enough to discuss it with missionaries or western colonial agents, it made sense to do it on younger girls. (Here, again, we reach the problem with discussing FGS as a monolith. Some cultures started out performing FGS on younger girls. But many didn't, and many of those started performing the surgeries on younger and younger girls.)

    Why is this a problem for women? Among other things, it decreases the likelihood of sexual function. Among the Kikuyu of Kenya, circumcision rituals were proceded with kinds of genital stimulation and body play that appear to have been intended to teach women how to orgasm once they had been cut. Adolescent girls and boys would wrap their bodies in tight strips of leather and rub up on one another. This kind of all-body stimulation is likely to have been instructive in helping women adjust to the altered physical sensations of a circumcized body. When circumcisions are done at a younger age, these kinds of rituals are likely to decline or disappear altogether.

    Women are also much more likely to acheive sexual pleasure after circumcision if they have orgasmed before circumcision. This is, obviously, more likely to be the case in girls who are adolescents than girls who are toddlers or infants.

    Circumcisions and younger ages also contribute to:

  • The destruction of social practices that surround circumcision, such as coming of age rituals, that provide context and meaning to the procedure. These contexts may not have anything to do with sexual pleasure (which is why I'm making this its own category), but are likely to have to do with community building and the function of a healthy culture. Destroying these rituals, but KEEPING the circumcision, is the opposite of good. The better option, of course, is to figure out how to keep the rituals while changing their object (as some activists have worked on doing).

  • Circumcision was often driven underground, to be done in private, furtive spaces, which makes it difficult for the procedures to be done in clean, healthy ways that minimize risk to the girls.

Perhaps the most important effect of banning FGS is that it created a dichotomy, the effects of which activists are still dealing with today. It underlined the idea that female genital surgeries are African, and not practicing female genital surgeries is American. Not to practice female genital surgery is to capitulate to colonialists. To practice FGS is to be genuinely African.

When Western feminists insist on framing the discourse about FGS on our terms, we make this problem worse. When we emphasize statements like, "African women are being denied sexual pleasure," as if it were the worst part of the situation, we grind home this dichotomy.

It has been repeatedly proven to be much more effective to talk about FGS in terms of women's and children's health. FGS kills women and children. According to a study linked by Feministe last year, women who've undergone infibulation are 50% more likely to die or to lose their infants than women who have not. Women who've undergone clitorodectomy are 15% more likely to die or to lose their infants in childbirth than women who have not.

This is the kind of information that tends to persuade women, because it is culturally situated. It addresses what they are worried about. Sexual pleasure tends to be coded as decadent and western. It is therefore not only not of concern, but can be specifically opposed. It's therefore not always useful to talk to African women about it. Our insistence on framing the narrative in our terms can damage African women's actual lives.

Because while sexual pleasure is a big deal, in my personal opinion, poor childbirth outcomes are probably a bigger deal. Spreading HIV through the use of dirty razor blades is a bigger deal. Injury and lameness are bigger deals. Uterine prolapse is a bigger deal. Death is a bigger deal.

There are real world harms to the ways in which westerners have typically framed debates about FGS. The dichotomy I mentioned earlier, where FGS is coded as genuine, African, and anti-colonial, gained teeth during the pan-African movement. Since that time, in some places, FGS has become a marker of cultural superiority. Cultures that did not practice FGM have taken it up, in order to emulate other cultures that are considered more prestigious. And other cultures that did not practice FGM have taken it up, specifically in order to show that they are African and anti-colonial. Our attempts to legally ban FGS have not lessened cultural attachment. They've increased it.

The Egyptian Ban, in Particular

FGS has been effectively banned in Egyptian hostpitals for some time. The original ban was put into place in 1997, although it left a loophole for "exceptional cases" in which surgeons were allowed to operate.

As of 2000, 97% of Egyptian women were circumcized.

What do we know about those procedures? Almost all of them were performed without the benefit of hospital medical care.

It is difficult, if not impossible, to calculate the number of girls' deaths that are caused by female genital surgeries. However, the procedure is risky. Clitorodectomy involves surgery near nerves and arteries. There are manifold risks to health, including bleeding out, cutting major tissue, and passing AIDS through non-sterilized equipment.

There are two ways to control those health risks. One is to provide adequate medical care. The other is to eliminate female genital surgeries.

Certainly, the second is preferable. But in the past 10 years of the ban on female genital surgeries, the number of circumcisions does not appear to have moved. A survey in 1995 shows the same rate of 97% that the 2000 study shows. In fact, the rate showed to be constant in 1997, 2000, and 2003. The ban has not had ANY effect on the practice of female genital surgeries. It has only made it unlikely that gilrs will receive adequate medical care -- and soon it will be impossible for girls to receive it.

If these figures are accurate, supporting this ban seems insane. Our stated goal is to improve the lives of women. This ban does not improve the lives of women. It makes female genital surgeries, which are going to be carried out with or without the ban, more medically risky.

I am reminded of pro-life advocate's devotion to the idea of outlawing abortion, ostensibly to prevent abortion, even when they are unwilling to take other measures that would actually prevent abortions, such as funding government-provided birth control. Are we actually dedicated to the idea of improving women's health, safety, and quality of life? Or are we more attached to the symbollic ban of something we don't like, placing the idea of women's sexual pleasure above the possibility that fewer girls -- who are going to be cut anyway -- will die, be maimed, or infected with HIV?

Solutions that Actually Work

There are solutions that actually work to reduce the incidence of FGS. Some activists are working on finding ritual substitutes for genital cutting that can stand in for the procedure, allowing the ritual function to continue without the surgery.

By far the most successful direct method has been educating women. Educated women are less likely to have their daughters circumcized, even in Egypt (this has some breakdowns by class). Educating women specifically about health is likely to dispell some of the myths that have grown up around circumcision, by showing that uncircumcized women are clean, and fertile, and can have children who do not suffer from hydrocephaly or death. It can also show the dangers of FGS, including the horrific child birth statistics listed above.

However, none of these methods are likely to be permanently effective until women in Africa have economic self-determination. They need to have enough money to be able to make their own decisions about FGS.

One chilling thing that has happened in the past is that activists have been able to convince families that FGS is a damaging practice. The families agree not to circumcize their girls -- and then the girls discover that there is no room for them in their society. Such girls have often agreed to be circumcized so that they will have a place in their cultures.

Women who are economically dependent can not make independent decisions about FGS. Money and education will allow them the power to choose.


Kristin said...

Thank you for all the information and thoughtful post, Rachel. I started thinking about foot binding after reading Nancy's post on women in Afghanistan on June 28th. We covered the topic in depth as part of a exploration of the status and role of women in a couple of Chinese history classes I had back in the late 80s-early 90s. Bound feet were considered beautiful but it was more complicated than that. Having bound feet (with all of the limited mobility it brought) implied status and wealth, since farm and other work was difficult to do, and also kept women under control and close to home. There were two things that stuck with me all these years from those classes. We saw a video that included three generations of Chinese women. A grandmother sat on a bench with her daughter watching her granddaughter play and run around the yard. She had had her feet bound at the age her granddaughter had just reached -- about 5 years old -- and she was elated that it was no longer practiced. Although she had loosened the bandages, her feet still ached and walking was difficult and painful for her. Despite this, she showed no bitterness, only joy in the freedom her granddaughter and daughter had. Since the reproduction restrictions were in place at that point, her granddaughter was the only child her daughter would have. The grandmother was thrilled that, despite the fact that she was a girl, her granddaughter was a welcomed and treasured child. I remember being amazed at the amount of cultural change that the three generations covered. The other thing I remember was a comment from one of my professors, a pro-democracy woman who had grown up in 50s China. She said that only the Communists could have eradicated foot binding and elevated the status of women in just one generation. She wasn't a fan of the Communists (she'd had to leave to avoid arrest) and didn't want to imply that they had brought equality when obviously they haven't. Since then, I've read that the women with bound feet were persecuted and discriminated against by the government. They must all be in their 70s and 80s now. Soon foot binding will just be history.

Laura MacDonald said...

This article seems very biased to me as and indeed female chauvinist in its denial that male genital cutting is comparable to female cutting.

It fails to mention for example that a common female circumcision (particularly in Egypt) is the removal of a woman's foreskin (sometimes with part of her labia).
Clearly this is directly comparable with male circumcision and yet it is entirely banned in many countries. In Egypt it has often been carried out on consenting, educated adult women - none of the newspaper reports told us that, did they?

It is known that incresing numbers of American women now choosing to undergo this type of circumcision. This is because they've absorbed all the male circumcision propaganda that says loose skin on the genitals is smegma-ridden and disgusting to a sexual partner.

Although on one level i have no problem with consensual female (or male) cutting, it is disturbing when a society creates this degree of body dysmorphia in its citizens.

The foreskin contains a huge number of nerve endings (around 3 times as many as the tip of the clitoris). We should be celebrating it, and thanking God/mother nature for the joy it brings both men and women.

One final point of clarification -
NO WOMAN HAS EVER HAD HER ENTIRE CLITORIS REMOVED. The clitoris is a mainly internal organ that is around six inches long. 'Clitorectomy' removes the visible tip of it.

A. said...

I agree with many of the points you make, in particular the necessity of avoiding colonialism. Nevertheless I don’t think you can discount any approach: all have their own worth and should form a full spectrum.

However I don’t like the term female genital surgeries. One of the problems that has come out of demonstrating the health hazards has been the medicalisation of FGM. Indeed the recent closing of the legal loophole in Egypt was precipitated by the death under anaesthesia of a girl undergoing FGM in hospital. Medicalisation lends a type of acceptability to the process.

Over the last few months I have been in contact with a blogger, Papillon, who lives in Paris. She is of Senegalese origin and suffered FGM at the age of four. She has been recounting her experiences since February as she decided to have reconstructive surgery (now that is what I would call female genital surgery). Her blog is in French although her mother tongue is Mandinka. I have, roughly, translated it in early part of my own blog. There are now a number of surgeons who perform reconstructive surgery.

Another person who suffered the same fate is Khady Koita. She campaigns against it as part of the organisation GAMS (Groupe femmes pour l’Abolition des Mutilations Sexuelles) and has written a book “Mutilée”, which give the account of her childhood in Africa and her unhappy married life in Paris.

Neither of them have any qualms about calling the procedure a mutilation and an abomination.

Dr Bogaletch Gebre is another campaigner against FGM who herself suffered it. As she says “One girl, one woman, one person at a time … it is thus that change will come”.

Rachel Swirsky said...


You mistakenly posted your comment in Eleanor's thread at first. My repsonse is there. Please read it before commenting again.


I understand that there are affected women who are comfortable calling it a mutilation and an abomination.

There are other women who have reported feelings of profound alienation form the terms, and I think it's important to include them in the discourse. It's their bodies that are affected.

Rachel Swirsky said...

(primarily their bodies)