Female genital mutilation

**Female genital mutilation** (**FGM**) is cutting off part or all of the female genitals that are outside of the body. FGM is also called **female genital cutting** and **female circumcision**. It is done for traditional reasons, as part of a ritual, not for medical reasons.

FGM is most common in 27 African countries, as well as Yemen and Iraqi Kurdistan. However, it also happens in other countries in Asia, the Middle East and around the world. Usually, FGM is not done by a doctor or in a hospital. It is often done with a razor blade or other sharp instruments, in many cases without anesthesia.

Different ethnic groups do different kinds of FGM. They also do FGM at different ages. Some groups do FGM when infants are only a few days old. Others do it when girls reach puberty, or are older. In about half the countries where FGM happens, most girls have FGM before they are five years old. FGM does not make a person's health better in any way.

FGM is illegal in most of the countries where it happens. However, these laws are often ignored. Since the 1970s, many countries have tried to stop FGM. In 2012, the United Nations General Assembly said that FGM is a human rights problem, and voted to try harder to stop it. The World Health Organization and the "Maputo Protocol" to the African Charter on Human and Peoples' Rights also say that FGM must be stopped.

## Types of female genital mutilation
There are many different types of female genital mutilation. The World Health Organization (WHO) has created four basic categories of FGM, called Types 1-IV.

### Type I
In Type I FGM, part or all of the clitoris is cut off. The clitoris is the female organ that makes sex feel good for women. Without it, a woman usually cannot have an orgasm.

### Type II
There are a few forms of Type II FGM. All of them involve cutting off part or all of the inner labia, the two flaps of skin on the sides of the opening to the vagina. The forms of Type II FGM are:
* Type IIa: The inner labia are cut off.
* Type IIb: The inner labia and part of the clitoris are cut off.
* Type IIc: The inner labia and part of the clitoris are cut off. So is the outer labia, the folds of skin that protect the genitals.

### Type III
Type III FGM is usually called infibulation. It is the most severe form of FGM. The genitals outside a woman's body are cut off and the wound is sewn shut with thread and thorns. The different types of infibulation are: To help the wound close, the girl's legs are tied together, often from hip to ankle, for up to six weeks.

After the woman gets married, her vagina is cut open so she can have sex. A midwife might cut open the vagina with a knife, or the woman's husband might tear it open with his penis. If the woman gets pregnant, the vagina is opened more for childbirth, and then often sewn back up afterward (this is called re-infibulation).

### Type IV
Type IV FGM is anything else that is done to hurt the genitals, like scraping, burning, scarring, or cutting the genitals without cutting them off. This procedure will be heartbreaking for women, when they get to know about this in later life.

## Prevalence 
In many countries where FGM is common, almost every woman and girl in the country has had FGM. In other countries, millions of women and girls have had FGM over many years.

In 25 countries in Africa and the Middle East, over 125 million women and girls have had FGM. This includes:

The type of complications that a girl or woman might have from FGM depend on many things, like:
* Swelling
* Dangerous bleeding
* Pain
* Trouble urinating normally
* Infection and trouble healing

More serious short-term complications can cause symptoms that can kill a woman. They include:
* Sepsis
* Tetanus
* Gangrene
* Necrotizing fasciitis ("flesh-eating disease")
* Bleeding to death

Nobody knows how many girls and women die from FGM.

### Late complications
Late complications happen later on after FGM is done. For example:
* Scars, which can block urine and blood from getting out of the body
* Cysts, which can become infected
* Have third-degree lacerations (very bad skin tears around the vagina) when they try to give birth
* Have damage to their anal sphincters from giving birth, affecting bowel control; and 
* Need emergency caesarean sections

FGM also raises the risk that a woman's baby will die soon after it is born. In 2008, the WHO estimated that 10–20 babies out of every 1,000 die because their mothers had FGM. All types of FGM were found to raise babies' risk of death, which was:
* 15 percent higher for Type I FGM;
* 32 percent higher for Type II; and 
* 55 percent for Type III.

### Effects on mental health & sexual function
There is not much information about the effects of FGM on women's and girls' mental health. However, a few small studies have found that women with FGM often have anxiety, depression, and post-traumatic stress disorder (PTSD).
* Women with FGM were twice as likely than other women to say they never felt like having sex
* Women with FGM were 52% more likely than other women to have dyspareunia (pain during sex)
* One-third of women with FGM had less sexual feelings than before their FGM.

## References