1. Changing a harmful social convention: FGM/cutting A report by United Nations Children’s Fund (UNICEF)

2. FGM/cutting Every year three million females are subject to genital mutilation/cutting This procedure is dangerous and potentially life threatening FGM violates basic human rights because it denies them of their physical and mental integrity

3. It is a global concern Occurs mainly in 28 countries Also is present in immigrant communities throughout the world

4. FGM/cutting Local languages generally use the less judgmental term “cutting” Parents understandably resent the suggestion that they are “mutilating” their daughters UN called for tact and patience regarding this and includes this term to avoid alienating communities

5. Social Dynamics It is an important part of girls’ and women’s cultural gender identity Imparts a sense of: Pride Of coming of age A feeling of community membership

6. If it is not done… Stigmatizes and isolates the girls and their family Results in loss of social status Female will have difficulty finding a husband Female will be seen as “unclean”

7. FGM/C ensures A female’s status Marriageability Chastity Health Beauty Family honor

8. Virginity FGM/C preserves a girl’s virginity Which is often a prerequisite for marriage For example, in Nigeria, mothers-in-law use FGM to verify virginity of the bride

9. Types of FGM/cutting Specific form of FGM/C can vary widely from community to community Difficulties associated with any classification system Females may not be certain of which procedure was performed on them

10. There is significant variation in the extent of cutting Procedure is commonly carried out without anesthetic Poorly lit conditions Girls often struggle to resist

11. Type I Refers to the excision of the prepuce with partial or total excision of the clitoris

12. Type II Partial or total excision of the labia minora Includes the stitching or sealing of it, with or without the excision of part or all of the clitoris

13. Type III Excision of part or most of the external genitalia Stitching/narrowing or sealing of the labia majora AKA “infibulation”

14. Type III (continued) Most common is the following countries: Sudan Eritrea Djibouti Somalia

15. Type III (continued) In Somalia and Sudan this type is carried out for the express purpose of making the girls physically “clean”

16. Type IV Makes specific reference to a range of miscellaneous or unclassified practices Includes stretching of the clitoris and/or labia Cauterization by burning of the clitoris and surrounding tissues

17. Type V Symbolic practices that involve the nicking or pricking of the clitoris To release a few drops of blood However, this practice does not address the gender-based inequalities that drive the demand for this May actually inhibit progress toward the abandonment of the practice

18. According to World Health Organization (WHO) 100-140 million women & girls have undergone some form of FGM/C Although it is done mainly in 28 countries Nearly half of these are from two countries Egypt & Ethiopia

19. FGM/C in the Middle East Some communities on the Red Sea coast of Yemen practice FGM/C Reports, but no clear evidence, of it in Jordan, Oman, the Occupied Palestinian Territories (Gaza), and some Kurdish communities in Iraq

20. Has also been reported in: India Indonesia Malaysia

21. Age when cut Egypt: 90% are cut between the ages of 5-14 Ethiopia, Mali and Mauritania: 60% are cut before their 5 th birthday Yemen: 76% are cut in the 1 st 2 weeks of life

22. “Medicalization” In some countries FGM/C is performed in hospitals and health clinics by medical professionals Fact that medical professions are known to be involved may contribute to a general misconception to FGM/C is somehow acceptable

23. According to WHO, FGM of any form should not be practiced by health professionals in any setting However, this has not stopped Egypt 61% of cases there have been done by medical professionals

24. Medicalization of FGM/C is on the rise Especially in Egypt, Guinea and Mali

25. Reasons why it continues “It is the norm that has to be fulfilled. The girl must be circumcised to protect her honor and the family’s honor, especially now girls go to universities outside the village and may be exposed to lots of intimidating situations.” From an interview with a woman in Upper Egypt

26. Similar to footbinding in China Footbinding is thought to have evolved in the context of a highly stratified empire The emperor and his elite used the practice to control the fidelity of their many female consorts With time this practice was adopted by families from lower strata

27. This way their daughters could marry into the higher strata Eventually footbinding became essentially signs in marriageability throughout China

28. Six key elements for change 1.A non-coercive and non-judgmental approach whose primary focus if the fulfillment of human rights and the empowerment of girls and women Despite taboos regarding the discussion of FGM/C the issue emerges because group members are aware of the harm it causes

29. 2.An awareness on the part of the community of the harm caused by the practice Must be non-judgmental and non- directive public discussion and reflection Costs of FGM/C will become more evident when people share their stories

30. 3.The decision to abandon the practice as a collective choice of a group that intramarries or is closely connected in other ways Most affective when community is acting together, rather than individuals acting on their own

31. 4.An explicit, public affirmation on the part of communities of their collective commitment to abandon FGM/C May take various forms Either joint public declaration in a large public gathering or an authoritative written statement

32. 5.A process of organized diffusion to ensure that the decision to abandon FGM/C spreads rapidly from one community to another and is sustained Where there was social pressure to perform FGM/C, there must now be social pressure to abandon it

33. 6.An environment that enables and supports change The media is crucial in this step

34. Physical damage Severe pain and bleeding are the most common immediate consequences of all forms of FGM/C Most done without anesthetic, so female may be in a state of medical shock

35. Infection is another common consequence Risk of infection can be increased by traditional practices, such as binding the legs or applying traditional medicines to the wound

36. FGM/C may be a contributory or causal factor in maternal death

37. Psychological damage Since most girls are conscious when performed for many there is acute pain, and fear and confusion Often psychosomatic disorders exist, too Disturbances in eating and sleeping habits Recurring nightmares Panic attacks PTSD Difficulties in learning or concentration

38. Urine retention is another common consequence “Deinfibultion” the procedure to re-open the orifice after it has been stitched “Reinfibulation” to re-stitch the vagina, usually performed after each birth