Female genital mutilation (FGM) is an intentional yet painful procedure that alters the female genital organs for non-medical reasons and ultimately has no health benefits for both girls and women. FGM takes place in at least 29 countries throughout the world, but usually occurs in third-world countries in the Middle East and Africa. The practice has suddenly come up in the United States with the first ever federal arrest and prosecution of a U.S. doctor for the practice. This human rights violation is contributing to the ongoing violence against women around the world and is having an ill effect on nearly two-million women globally and continues to prey upon nearly three-million girls every year. The reasons why female genital mutilation is still being practiced are inaccurate and flawed in logic. The medicalization of the practice due to increased migration between countries is causing the spread of FGM. The immediate complications of FGM on women and the long-term effects of the procedure are contributing to the harsh violence society puts towards women globally. 

Female genital mutilation involves the removal of the clitoris, inner-and-outer lips of the vagina, and the sewing or stapling together of the two sides of the vulva leaving only a small hole to pass urine and menstruation, depending on the type of procedure. Typically performed with a razor blade on girls between the ages of four and 12, traditionally without anesthetic, the practice is carried out by traditional circumcisers, who often play other central roles in communities. FGM can lead to severe bleeding, pain, complete loss of sensitivity, complications during childbirth, pain during sex, post-traumatic stress disorder, cancer, recurring infections, and urine retention; they are forever alienated from their bodies and it is consequential (Muteshi). The procedure also inhibits sexual pleasure. There are no health benefits and surgery is sometimes required in later life to open-up or seal the vagina again. 

Why is FGM practiced? Where female genital mutilation is a social norm, Africa and middle-eastern countries, the social pressure to conform to what others have been doing as well as the need to be accepted socially and the fear of being rejected by the community are strong motivations to perpetuate the practice.  In some communities, FGM is almost universally performed and unquestioned (Muong). Community leaders of power and authority may also contribute to the upholding of the practice. The procedure can also be seen as a necessary part of raising a girl and a way to prepare her for adulthood and marriage. FGM is seen to ensure premarital virginity and marital fidelity; to reduce a woman’s libido and help her resist extramarital sex (Khosla). The practice is associated with cultural ideals of femininity and modesty, which include the notion that girls are clean and beautiful after removal of body parts that are considered unclean, unfeminine, or male (Muteshi). Though no religious scripts about the practice have been recorded, supporters, particularly those in the United States, believe the practice has religious support.  More than 200 million girls and women are living with FGM today and have been cut in 30 countries in Africa, the Middle-East, and Asia, but due to the increase in migration of immigrants and “cutting vacations”, FGM is being seen in more civilized European countries like Great Britain and the United States (Muong).

Female genital mutilation is a ritual practiced in more than 30 countries, and has been banned in the U.S. for the last 21 years, however just over half of states criminalize the practice and even less internationally. At least 513,000 girls in the U.S. alone, are at risk for FGM. Thirty-thousand of those women are living in Virginia; this is due to the high level of immigrants who come to the state from cultures where FGM is a regular practice (Thoet). Activists view a federal case taking place in Detroit, Michigan as a landmark case that could finally bring widespread attention to FGM in the U.S. Although FGM is considered illegal, people still practice it and use the defense of the First Amendment, the Freedom of Religion, in support of the practice (Dancer). The first ever federal charges of female genital cutting are taking place against a Michigan doctor and his wife for preforming the procedure on dozens of girls traveling from Minnesota with their families. The original criminal charge states that Jumana Nagarwala performed FGM on two seven-year-olds. The girls said that they were traveling from Minnesota to Detroit for a “special girls’ trip” with their parents. Their parents had taken them to the doctor to “get the germs out of their stomach” (Bess). The girls said that they had gotten a shot in their private area and then they weren’t able to walk.  

The main argument of the defense is that FGM (in the United States) is protected under the First Amendment. Visiting criminal law scholar at the University of Houston Law Center, Melissa Hamilton stated that, “Winning a religious freedom case as against criminal laws that apply to all is very difficult. In this case, causing physical injury to young girls who cannot fully consent to it is of greater importance.” (Bess). In history of religious freedom in the United States, Thomas Jefferson wrote a letter indicating that there was a distinction between religious belief and action that flowed from religious belief. The former “lies solely between man and his God,” therefore “the legislative powers of the government reach actions only, and not opinions.” (Thoet).

The defendants in the federal case are all a part of the Dawoodi Bohra community, which is an Indian-Islamic sect. Many women from this sector have come out against the practice, but many women endorse FGM for “religious purity” without mentioning extreme pressure and guilt from family and friends (Khosla). For the practice to continue, younger generations have to do what their ancestors, grandmothers, mothers, and sisters have done; if you don’t, then you won’t get married, you won’t be a woman, and you will be eventually ostracized from the community.  Gabby Bess, journalist for the Broadly, cautioned that this case should not be exploited to fuel Islamophobia in the US. FGM is a widely known cultural practice of all faiths and socioeconomic classes (Bess). Legal professionals think that the argument won’t hold up in court because there is no constitutional right to an exemption from a law of general applicability based on religious belief (Bess). Neal Davis, another criminal defense attorney, explains that FGM is more cultural than religious due “to the lack of Islamic or Christian scripture mandating the practice of FGM, the First Amendment does not apply. Rather, FGM is a tradition or custom that is not protected under the First Amendment” (Dancer).

The ACLU director states that the freedom of religion, “doesn’t allow any of us to ignore laws protection people from harm.” (Thoet). This case is landmark hearing not only for the nation, but for our world based off of increased societal pressure, normalizing the practice justified by the First Amendment. If a federal court rules against the practice, it will put pressure on other countries to abolish and criminalize the procedure. Ultimately, the question for the court is whether or not hurting children in support of cultural and religious beliefs okay.

The intense numbers of immigrants migrating to other countries, FGM is spreading to countries that have not previously practiced it; in some cases, it even may be illegal. Globalization and immigration place thousands of girls and women from countries with a long history of female genital cutting in countries with little or no history of the practice. The sudden exposure to FGM causes differing attitudes among immigrants toward female genital cutting from attitudes in home countries due to selective migration (Khosla). Contrasting viewpoints of FGM show that immigrants feel as though programs aimed at preventing and making others knowledgeable on FGM, actually make immigrants feel prejudged, misrepresented, and attacked. Highlighting discordant views on FGM within a cutting society can significantly improve attitudes towards uncut girls. The actual studies that are of any importance are directed at understanding the differences between migrants and nonimmigrants and the variation within immigrant populations. 

 The critique of the explanation of cutting and the tremendous differing of explanation, gives an opportunity to develop culturally sensitive interventions that promote abandonment by turning to patriarchal viewpoints within the cutting society which further contributes to the violence against women (Vogt). Policy makers need better data on the distribution of attitudes regarding FGM in order to provide better estimates of cutting practices among immigrants and by extension better policy recommendation. Since FGM can cause later problems that have to be solved by additional surgeries, physicians around Europe and the States, due to migration and increased immigration, are seeing the effects of FGM firsthand and learning how to deal with its consequences.  

An increasing number of trained health-care providers are starting to carry out the practice at the request of families. It is important to understand the motivations of providers in order to reduce the medicalization of FGM. Main motives from health-care providers are the belief that performing FGM is less harmful to girls if the procedure is being performed by a trained profession, cultural beliefs, financial gains, and responding to the requests of the community or feeling pressured by the community to perform the procedure (Vogt). FGM is becoming more normalized and being seen in more civilized countries, like the United States and Great Europe.  Violations of women and girls’ human rights have significant implications for the work of health care providers from a human rights and gender equality perspective. From a human rights standpoint, caregivers have a moral obligation to address and impede the practice of FGM and stop the continuance of the horrific procedure against woman (Doucet). As an act of violence, care providers have the obligation to try to educate the general public and prevent the practice because it is one that generates serious long-term health consequences for women and girls living with FGM (Muong). Education, tends to be associated with reduced support for female genital cutting. More educated mothers might be more likely to understand that cutting is not a religious obligation and can involve health risks. It is critical to ensure that the particular health issues of women who have undergone FGM, as well as ensuring that quality sexual and reproductive health care services are available, accessible, and considered of high quality in order to ensure that all women can exercise the highest standard of living (Doucet). 

As mentioned earlier, immediate complications of FGM depending on the severity of the procedure can include severe pain, excessive bleeding, genital tissue swelling, fever, infections (tetanus), urinary problems, wound healing problems, injury to surrounding genital tissue, shock, and death (Muteshi). Long-term consequences that the practice can produce are painful urination, urinary tract infections, vaginal discharge, itching, bacterial vaginosis, painful menstruations, scar tissue, keloids, pain during sexual intercourse, decreased satisfaction, difficult delivery during childbirth, need for later surgeries – the FGM procedure that seals or narrows a vaginal opening needs to be cut open later to allow for sexual intercourse and childbirth and sometimes genital tissue is stitched again several times, including after childbirth, hence the woman goes through repeated opening and closing procedures – depression, anxiety, PTSD, and low self-esteem (Muteshi).

Female genital mutilation is recognized internationally as a violation of the human rights of girls and women. It reflects deep-rooted inequality between the sexes, and constitutes an extreme form of discrimination against women. The practice also violates a person’s rights to health, security and physical integrity, the right to be free from torture and cruel, inhuman or degrading treatment, and the right to life when the procedure results in death. As influential the United States is, the court needs to make sure they make the right decision regarding the future of female genital mutilation domestically and globally. 
