Female Genital Mutilation

(1)

FEMALE GENITAL

MUTILATION

(A Limited Medical Perspective)

ASRI TADDA ASRI TADDA

LEMBAGA KAJIAN PEMBANGUNAN KESEHATAN (LKPK) LEMBAGA KAJIAN PEMBANGUNAN KESEHATAN (LKPK)

(2)

What is “Female Genital”?

GENITALIA EKSTERNA GENITALIA EKSTERNA - Labia Mayora - Labia Mayora - Labia Minora - Labia Minora - Bartholini Gland - Bartholini Gland - Clitoris - Clitoris - Preputium - Preputium - Payudara* - Payudara*

GENITALIA INTERNAGENITALIA INTERNA

- Introitus Vagina - Introitus Vagina - Servix/Uterus - Servix/Uterus - Ovarium - Ovarium

(3)

“

Female Genital Mutilation”

_{Female Genital Mutilation”}

“

Semua prosedur yang dilakukan untuk

mengeluarkan sebagian atau

keseluruhan, atau bentuk2 perlukaan lain

atas organ genital (eksternal) perempuan,

baik didasari budaya, agama/kepercayaan

atau alasan2 non-terapeutik lainnya.”

(WHO, Fact Sheet No 241, June 2000)

(4)

Classification

 Type I Type I ((Clitoridotomy/hoodectomy/Sunna Clitoridotomy/hoodectomy/Sunna

circumcision

circumcision) : ) : excision of the prepuce, with or excision of the prepuce, with or without excision of part or all clitoris

without excision of part or all clitoris

 Type II Type II (Clitoridectomy)(Clitoridectomy) : : excision of the clitoris excision of the clitoris

with partial or total removal of the labia minora

 Type III Type III ((InfibulationInfibulation) : ) : excision of part or all of excision of part or all of

the EG and stitching or narrowing of the vaginal

opening

 Type IV Type IV (The other type(The other type) : ) : Combination Combination

procedure/the other types)

Fact : up to 80% (I and II), about 15% (III)

(5)

Reasons

Psychosexual : Psychosexual : reduction/elimination of the reduction/elimination of the

sensitive tissue of the outer genitalia, sensitive tissue of the outer genitalia,

particularly the clitoris, to attenuate sexual particularly the clitoris, to attenuate sexual

desire in the female, virginity, increase male desire in the female, virginity, increase male

sexual pleasure, etc sexual pleasure, etc

Sosiological : Sosiological : identification with cultural identification with cultural

heritage, initiation of girls into womanhood, heritage, initiation of girls into womanhood,

social integration, maintenance of social social integration, maintenance of social

cohesion, gender identity cohesion, gender identity

(6)

 Control of women’s sexuality and reproductive Control of women’s sexuality and reproductive

functions :

functions : preventing woman from ‘illegitimate’ preventing woman from ‘illegitimate’ sex and protecting from unwilling sexual

sex and protecting from unwilling sexual

relations

 Hygiene and aesthetic : Hygiene and aesthetic : EG of female are EG of female are

considered dirty & unsightly.

 Myths : Myths : enhancement of fertility and promotion of enhancement of fertility and promotion of

child survival

 Religious : Religious : some muslim communities ~ some muslim communities ~

geographical custom

geographical custom, Ethiopian Jewish , Ethiopian Jewish community (Beta Israel/Falasha)

(7)

Testimony

“

“FGM was inherent in the initiation which is itself FGM was inherent in the initiation which is itself an essential part of being Kikuyu. Abolition…will

an essential part of being Kikuyu. Abolition…will

destroy the tribal system”

((Jomo Kenyatta, the late President of Kenya)Jomo Kenyatta, the late President of Kenya)

“

“Of course I shall have them circumcised exactly Of course I shall have them circumcised exactly as their parents, grandparents and sisters were

as their parents, grandparents and sisters were

circumcised. This is our custom.”

((An Egyptian woman, talking about her young An Egyptian woman, talking about her young

daughters)

(8)

Other Testimony

““We are circumcised and insist on circumcising our We are circumcised and insist on circumcising our

daughters so that there is no mixing between male and

female….An unsircumcised woman is put to shame by

her husband, who calls her ‘you with the clitoris’. People

say she is like a man. Her organ would prick the man..”

((An Egyptian woman)An Egyptian woman)

““Circumcision make woman clean, promotes virginity and Circumcision make woman clean, promotes virginity and chastity and guards young girls from sexual frustration

chastity and guards young girls from sexual frustration

by deadening their sexual appetite”

(9)

GEOGRAPHICAL DISTRIBUTION



135 million women have undergone FGM



2 million girls a year are at risk of FGM

…………

6000/day!

FGM practised extensively in Africa (more

than 28 countries), Middle East, Asia,

UAE, UE, USA, and the other nation

(10)

HEALTH CONSEQUENCES



Physical



Sexuality and Reproductive



Psychological

(11)

Physical Risk



Death



Anaesthetic trauma/pain



Bleeding/haemorrhage shock



Infections (urinary, reproductive, HIV)



Damage to the organ, keloids, dermoid cysts



Small benign tumours of the nerve

(12)

Sexual Risk

Dyspareunia Dyspareunia

Reduce women’s enjoyment of sex experiencesReduce women’s enjoyment of sex experiences InfertilityInfertility

Obstetric riskObstetric risk ( (according to WHO recent study, 1_{according to WHO recent study, 1}stst of _of

June 2006

June 2006) : ) : death to the babydeath to the baby (15% for type I, 32% (15% for type I, 32%

for type 2, and 55% for type III), 30%

for type 2, and 55% for type III), 30% caesarean caesarean sections

sections and 70 % and 70 % postpartum haemorrhagepostpartum haemorrhage for for type III

(13)

Phsycological Effect



Psycological illness related to FGM, such as

: anxiety, terror, long-term negative effects



Trauma experienced post GM



For the woman undergo GM;

Feeling that

she is acceptable to her society, having

upheld the traditions of her culture and

made herself eligible for marriage

(14)

Medical Benefit of FGM

FGM could cure woman from “illnesses”

such as anxiety, epilepsy, nervous and

“excessive masturbation”…….

(19(19thth Century England…)_{Century England…)}

(15)

Resume

……

.today, the argument become a big

controversion………

In fact, there is no significant medical benefit

to practice Female Genital Mutilation…That is

just subjective reasons….

(16)

Stop!

Female Genital Mutilation

Now!

Thank You…

(17)