This book provides a state-of-the-art review of what is currently known about the practice of female genital mutilation, its prevalence, its short- and long-term consequences for physical and mental health, and the social factors that encourage its perpetuation. Past and present policies aimed at ending the practice are also reviewed in detail. By drawing together a large body of medical and scientific facts, the book aims to provide a firm foundation for action within a climate of strong global consensus that female genital mutilation must end. Some 125 references to the literature are included in this thoroughly researched, scholarly account.
The book has seven concise chapters. The first provides an historical review, dating back to the mid-19th century, of various classifications of female genital mutilation, including those most recently adopted by WHO and other international agencies. Procedures employed in each of four types of female genital mutilation are also clearly described and defined. Chapter two, on prevalence and epidemiology, summaries what is known about the global prevalence of this practice and profiles the situation in each of 28 countries and in refugee and immigrant populations in Australia, Europe, North America, and Israel. In reviewing published studies, the authors make a special effort to determine the strength of reported evidence and thus ensure a balanced understanding of the extent and geographical distribution of this practice. Some two million girls are estimated to be at risk of undergoing some form of the procedure every year.
Chapter three provides a factual, well-documented account of the many complications linked to the different types of female genital mutilation. Basic information about the development and functional anatomy of the external female genitalia underscores the difference between male circumcision and female genital mutilation. Evidence of adverse effects on both female and male sexuality is also critically reviewed. Research is assessed in the next chapter, which identifies several important gaps in current knowledge. Precise suggestions for further research are given in the areas of epidemiology, health effects, behavioral determinants, and program design and evaluation. Noting that female genital mutilation is a culturally sensitive issue deeply rooted in tradition, the authors point to the urgent need for applied or operational research on how to design interventions that would convince individuals and communities to change traditional beliefs and behaviors.
Chapter five describes international, regional, and national legal instruments which relate to female genital mutilation. A discussion of ethical issues also considers the widespread controversy about whether a mild procedure, performed by medially trained personnel, is an acceptable option. The remaining chapters summarize WHO policies and activities, and set out a number of conclusions that should prove useful in guiding the actions of activists, international agencies, and nongovernmental organizations committed to ending this brutal and humiliating practice. (Publisher)