Female genital mutilation (FGM)

Definition

• According to the WHO, female genital mutilation comprises all practices that partially or totally cut away the external female genitalia or otherwise injure the female genital organs for non-medical reasons.

Classification

• Type 1: partial or total cutting of the clitoral glans and/or the clitoral prepuce.
• Type 2: partial or total cutting of the clitoral glans and labia minora, with or without the labia majora.
• Type 3 (infibulation): narrowing of the vaginal opening by a covering seal formed from cut and repositioned labia minora or majora, with or without cutting of the clitoral prepuce and glans.
• Type 4: all other harmful practices for non-medical purposes such as pricking, piercing, incising, scraping or burning the genital area.

Occurrence & epidemiology

Epidemiology

• More than 230 million girls and women alive today have been affected, mainly in countries in Africa, the Middle East and Asia.
• The practice is mostly carried out on girls between infancy and age 15, and occasionally on adult women.

Clinical features

• Acute risks include severe pain, haemorrhage, swelling, fever, infections such as tetanus, urinary problems, wound complications, injury to surrounding tissue, shock and death.
• Long-term consequences include urinary and vaginal infections, menstrual problems, scarring and keloids, cysts, sexual problems, childbirth complications and psychological sequelae such as depression, anxiety and post-traumatic stress disorder.
• All forms are associated with an increased risk of complications, which is greater with more severe forms.

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Further reading (selection)

1. WHO fact sheet: Female genital mutilation
2. StatPearls: Female Genital Mutilation or Cutting (NCBI Bookshelf)

Cross-references