Female genital mutilation Associate Professor Ben Mathews Health Law Research Program QUT Faculty of Law

What I’ll cover briefly today: 1. The nature of FGM 2. Physical and psychological health consequences 3. Australian laws prohibiting FGM 4. Recent developments in Africa 5. Can an absolute human right against FGM emerge?

1. The nature of FGM The deliberate, non-therapeutic physical modification of female genitalia, usually in young girls (approx age 5-7) 4 forms (may be administered individually or in combination): 1. clitoridectomy (partial or total removal of the clitoris); 2. excision (partial or total removal of the clitoris and the labia minora, and sometimes also the labia majora); 3. infibulation (narrowing of the vaginal opening); 4. all other harmful non-therapeutic procedures (including pricking and incising) Types 1 and 2 more typical But infibulation is estimated to affect 10% of those who have experienced FGM; especially likely in Djibouti, Eritrea, Ethiopia, Somalia, and Sudan

In which societies is FGM most often conducted? Concentrated in some African nations (especially Islamic) but reported worldwide 11 African nations have rates of FGM in females aged of 70-98%: Somalia, Egypt, Guinea, Sierra Leone, Djibouti, Sudan, Eritrea, Gambia, Ethiopia, Burkina Faso and Mauritania How many? million girls and women now alive 3 million girls in Africa at risk each year Why is it conducted? Historical records since 450BC; so predates, and has no basis in, Koran or Bible A cultural tradition, motivated by a patriarchal social desire to control females’ bodies, roles, and capacity for sexual enjoyment and fulfilment: ensure virginity at marriage (preserving family honour) help attract a husband (uncircumcised women seen as immoral) prevent infidelity by limiting sexual desire rite of passage into womanhood

2. Physical and psychological health consequences Often conducted in unsterile environments (no anaesthetic, antiseptic or antibiotics), by persons with no surgical training (often female family member, or women from community), using implements such as stones, razors, glass Fatalities: risk of infection is high; death from haemhorraging is not infrequent Physical injuries The more invasive the FGM, the greater the complications for intercourse, menstruation, recurrent infections, chronic pain, childbirth and perinatal death Those who are infibulated suffer re-incision to facilitate intercourse and childbirth, with higher risk for fatalities in childbirth Significant effects on longevity Psychological consequences Post-traumatic stress disorder Depression Anxiety Fear of sexual relations

3. Australian laws prohibiting FGM USA and Australia, 2010: peak medical bodies considered endorsing the medical administration of a ‘lesser’ form of FGM – ‘ritual nicks’ Proposals quickly overcome Australian criminal prohibitions Every State and Territory (eg Criminal Code Act 1899 (Qld) s 323A) Legislation prohibits performance of any type of ‘female genital mutilation’, defined as including clitoridectomy, excision of any other part of the genitalia, infibulation (narrowing or closing of the vagina), and any other mutilation of the genitalia Also prohibits taking child out of country for performance of FGM: s 323B

4. Recent developments in Africa: legal, practical Legal developments: FGM has been made illegal by a growing number of nations (at least 16) Also prohibited by the Protocol to the African Charter on Human and Peoples’ Rights 2003 (the Maputo Protocol) Consistent with other international instruments: Convention on the Elimination of All Forms of Discrimination against Women 1979 (articles 1, 2, 5, 12) United Nations Convention on the Rights of the Child 1989 (articles 19, 24, 34). But note that legal prohibition (and even enforcement), while a positive step, will never by itself be sufficient to create real change: example of Egypt (2007 law; decline pre- and post-law; yet still conducted post-law especially by GPs; 1 in 3 young doctors defended FGM, thinking it was required by religion) attitudinal change is also necessary to produce practical change

Practical strategies: Educating the public about FGM (cooperation between government and nongovernment agencies, religious leaders, societal opinion leaders and health experts) Using culturally and linguistically appropriate methods of communication with the community (eg theatre and role-play), to heighten awareness of the issues and catalyse self-starting cultural change Education of young girls (since mothers play a major role in FGM of their daughters) Promoting awareness of key human rights instruments Involving men and community leaders in these educational and awareness- raising efforts including facilitating conversations between men and women who have suffered FGM – the simple act of talking – facilitates understanding, empathy, compassion and attitudinal change

5. Can an absolute human right against FGM emerge? An intriguing possibility : League of Nations’ Declaration of the Rights of the Child 1948: Universal Declaration of Human Rights: childhood requires special care and assistance 1959: Declaration of the Rights of the Child: ‘the child, by reason of his [or her] physical and mental immaturity, needs special safeguards and care, including appropriate legal protection’ (Pr. 2). 1990: United Nations Convention on the Rights of the Child enters into force Article 19 obliges States parties to take all appropriate legislative, administrative, social and educational measures to protect children from all forms of abuse and exploitation 2003: Maputo Protocol (African Charter on Human and Peoples’ Rights 2003) ban on FGM 2005: Islamic context: Rabat Declaration on Child Issues art 10: eliminate discrimination against girls and harmful traditional practices such as FGM and child marriage; art 20: take legislative measures But note: distinction between theoretical ‘rights’, and legal ‘rights’, and rights in practice Law/theory vs attitudes and practice: the requirement of attitudinal change regarding gender (and gender roles), sexuality, society, children and violence

Key publications B Mathews, ‘Female genital mutilation: Australian law, policy and practical challenges for doctors’ (2011) 194(3) Medical Journal of Australia See also: D Barstow, ‘Female Genital Mutilation: The Penultimate Gender Abuse’ (1999) 23 Child Abuse & Neglect S Rasheed, A Abd-Ellah and F Yousef, ‘Female genital mutilation in Upper Egypt in the new millennium’ (2011) 114 International Journal of Gynecology and Obstetrics M Rajabi-Ardeshiri, ‘The Rights of the Child in the Islamic Context: The Challenges of the Local and the Global’ (2009) 17 International Journal of Children’s Rights K Morris, ‘Issues on female genital mutilation/cutting-progress and parallels’ (2006) 368 Lancet S64-S66. W Wakabi, ‘Africa battles to make female genital mutilation history’ (2007) 369 Lancet