Applied Psychology OPUS

Perceptions of Womanhood: A Discourse on Female Genital Mutilation

by Melissa Fulgieri

Female genital mutilation (FGM), also known as female circumcision, as defined by the World Health Organization (2010), comprises all procedures that involve partial or total removal of the external female genitalia, or other injury to the female genital organs for non-medical reasons. Four types of procedures comprise FGM, including: circumcision, or the cutting the prepuce or hood of the clitoris; excision, or the removal of all or part of the clitoris and labia minora; and infibulation, the cutting of the clitoris, labia minora, and at least part of the labia major. In particular, infibulation involves joining the two sides of the vulva together, narrowing the vaginal opening to only allow for either the flow or urine or menstruation. The fourth type of FGM is labeled "other," including all other harmful procedures to the female genitalia for non-medical purposes. FGM is most widely performed in more than twenty countries in Africa, specifically in the western, northern, and eastern regions of the continent. Additionally, FGM is routine in certain parts of the Middle East and Asia, specifically among the Muslim populations of Indonesia and Malaysia, and among the Bohran Muslims in India, Pakistan, and East Africa (Dorkenoo, 1994). Despite such prevalence, the exact origins of FGM remain unknown. Evidence dates FGM back to ancient Egypt, the custom potentially growing from the ancient Egyptian belief in the bisexuality of Pharaonic gods (Assaad, 1980). In this ancient belief, individuals were said to have two "souls," one masculine and one feminine. These souls were believed to reside in the individual's opposite sexual organ and it was understood that in order to descend into womanhood, an adolescent girl needed to remove the part of her that contained her "male" soul, or the clitoris (Assaad, 1980).


At first glance, there seems to be an overwhelming surge of advocacy against the tradition of FGM in Ghana, and in a larger sense, West Africa. It has been found that an estimated 100 million to 140 million girls and women in the world today have undergone some form of FGM and two million are expected to partake in the practice each year. The continent of Africa, where FGM exists in at least twenty-six countries, remains the region of the globe where women are most susceptible to undergoing the procedure (Kouba, 1985). Consequently, many organizations worldwide are focusing their efforts on completely eradicating the practice in Africa and other parts of the world. In fact, in 1997, the World Health Organization issued a joint statement with the United Nations Children's Fund (UN-ICEF) and the United Nations Population Fund (UNFPA) condemning the practice of FGM (World Health Organization, 2010). Despite efforts to eradicate FGM, the practice persists due its support as a rite of passage by those who live where FGM is widely prevalent. While the World Health Organization estimates that between 100 to 140 million girls and women worldwide have undergone the procedure, many women who advocate for its continuation have been circumcised themselves. Therefore, it is difficult to separate an understanding of the potential physical effects of FGM (including chronic urinary tract and pelvic infections, uncon-trolled bleeding, complications during childbirth, infertility, severe pain during intercourse, and formation of deltoid cysts) from culturally constructed motives for support of FGM despite such effects. Furthermore, beyond these physical effects are possible psychological results of the procedure, which may include terror and chronic anxiety, depression, post-traumatic stress disorder, and other demonstrations of trauma and humiliation (Dorkenoo, 1994).

Although such effects have been reported, there is need for further research, as many women demon-strate only subtle psychological symptoms possibly indicating repression, denial, and acceptance of social norms (Toubia, 1994). The opposing viewpoints on FGM create a divide between activist groups who are adamantly against the procedure and yet have never experienced it firsthand, and those who grew up in a society, such as rural Ghana, which recognizes the normalcy of female circumcision and therefore fervently believe in continuing the procedure for young girls. Because of this divide, it is important to consider the cultural systems entangled in our understanding of FGM. In my reflection, I hope to discuss the rural Ghanaian perspective on FGM and how it relates to the opinions of Western culture. I also intend to explore the potentiality of FGM enhancing or diminishing one's own sense of womanhood depending on ideologies that pertain to this difference in geographical locations.

Many Ghanaian organizations are working to eradicate the procedure of FGM through the implementation of laws, education and outreach programs. Although Ghana was the first country to criminalize FGM in 1994, Ghanaian advocacy groups continue to focus their efforts on generating stricter laws that more effectively prevent the procedure. The existing law demands that those who are prosecuted face a prison sentence of at least three years. However, the Ghanaian Association for Women's Welfare (GAWW) has proposed that family members who allow their daughters to undergo a circumcision procedure should also be liable for punishment, not solely the practitioners who perform the procedure. Additionally, the Ghanaian chapter of the International Federation of Women Lawyers (FIDA) has called for stricter laws that penalize those performing the procedure (Medical News Today, 2004). An additional law supporting the criminalization of FGM in Ghana includes the Domestic Violence Act of 2003, which protects the rights of women and children. Although the act is not specifically geared towards criminalizing FGM cases, it protects the victims of all cases of violence against women (Ako, 2009). The implication of including FGM in this law suggests that the procedure is in fact seen as an act of violence against women. There have been many Western, outsider efforts to see that the prevalence of FGM procedures ceases. In 1997, the World Health Organization (WHO) and the United Nation Children's Fund (UNICEF) issued a joint statement against the practice of FGM. A February 2008 statement from WHO and UNICEF was met with support from the United Nations because it provided new evidence regarding the practice of FGM and increased recognitions of human and legal rights violations. The statement put forth new information on the damaging effects of FGM on women, girls, and newborn babies as mentioned above (Toubia, 1994).

Efforts from Western culture to stop FGM have since included: reconstruction of legal frameworks within countries that widely practice the procedure; and the development of international involvement groups that raise awareness and advocacy against FGM. Such groups believe that if practicing communities decide to abandon FGM as a medical procedure, the cultural practice will be eliminated quickly, and therefore these groups spread awareness about FGM as a harmful medical procedure. In 2008, the World Health Organization focused on three categories of assistance in eliminating FGM: participation in international, regional, and local efforts; generating knowledge about the causes and consequences of the practice by conducting various research projects; and guidance for health professionals on how to treat women who have undergone procedures (WHO, 2010).


Although the medical practice of FGM was made illegal in Ghana in 1994, the interminable opinion of those living in Northern Ghana, is that the procedure is culturally and practically necessary. Groups that still widely practice circumcision are the Frafra, among other communities in the north and various communities in the capital city of Accra, such as the Nima and Madina, who contain large concentrations of migrants from the north (Ankomah, 2010). These commun-ities continue to view the procedure as an important ritual that marks the transition from childhood to adulthood. Despite the existence of the law, FGM is still practiced in these areas while most of the perpetrators remain unprosecuted (Medical News Today, 2004). Protectors of the ritual believe that FGM is necessary for a girl to enter womanhood. In fact, the ceremony surrounding the actual procedure traditionally is seen as a social function that symbolizes puberty (Ankomah, 2010). More specifically, it is believed that during the ceremony a woman is given the skills and information needed to complete her many duties as a wife and a mother. Other cultures outside of Ghana believe that if you are not circumcised, you are simply less of a woman. For example, many practicing communities believe that FGM is preferable and makes a woman more hygienic and aesthetically pleasing since female genitalia is viewed as ugly, offensive and/or dirty (IRIN News, 2004). In such cultures, the procedure is also believed to be necessary in reducing a woman's sexual desire, thus ensuring virginity at marriage (Razor's Edge, 2005). In fact, women who have not undergone the procedure are believed to have uncontrollable and overactive sex drives, which the culture views as a sign of inevitable promiscuity and adultery. As mentioned above, the most invasive circumcision procedure, infibulation, involves removing all female genitals, including clitoris, labia majora, and labia minora and stitching up a single, small opening that is meant for urine and menstrual flow. This procedure has the same intent but also reduces the size of the vaginal canal, aiming to increase the husband's enjoyment of sexual intercourse. This ideology causes many advocacy groups against FGM to assert the "bodies of young girls affected by FGM are literally molded [towards] male satisfaction" (Akintunde, 2010, p. 193).


Other communities carry out the procedure because they believe that FGM makes a woman more fertile and thus increases the chances of her children's survival. Others believe that the clitoris has the power to kill a baby if it comes into contact with the child during childbirth, as the secretions of the clitoris are also believed to kill sperm. As discussed, the very foundations of FGM as understood and performed in rural Ghana suggest that the sexuality of a woman is dirty, unsightly, and un-necessary. Furthermore, the existence of a woman's sexual exploration is seen as posing a threat to the status and opportunities of a man (Braddy, 2007), and thus FGM is believed to be essential. Perhaps the reason for such an impediment in eliminating FGM is a result of the major discrepancy between FGM-supporting and Western cultures' ideologies regarding gender inequality. Western cultures, which represent a majority of the groups advocating against FGM, have made a conscious attempt to eliminate gender inequality in their societies. On the other hand, the cultures that continue to perform FGM are still plagued by fervent gender inequality that is not only fostered by males, but also by the women elders who see no other alternative way of life. In other words, in societies where women rely on community and spousal support for survival, a decision to forgo circumcision may have negative outcomes, such as shame for the woman's family and exclusion from the society. As a result, women themselves are often the strongest advocates of the practice, because they believe it will "ensure necessary advantages for their female children" (Braddy, 2007, p. 158). It seems as though gender inequality is an integral part of a society's promotion of FGM and therefore, the predominance of FGM as a procedure may be a function of the strict gender roles that have been socially constructed and maintained for years. With the existence of FGM, young girls are taught to believe that having any sexual pleasure is strictly allotted to their husband and that the possibility of their own sexual desire is disgusting and in-appropriate (Braddy, 2007). Thus, a vicious cycle is perpetuated between men who have sense of ownership over women and women who have been brought up believing this is the norm or status quo. With these foundations strictly in place, it's no surprise that womanhood means a very different thing in rural Ghanaian communities than it means in Western culture. Even though a woman herself may not agree with FGM, she will most likely experience pressure from society, which dictates the status quo regardless of her viewpoint. For example, families often coerce their daughters to undergo the procedure because it makes them more marriageable and marketable to the other sex. The operation ensures their daughters will have willing suitors and ensures them a suitable bridal price. In fact, many men will not even consider marrying a girl who has not been circumcised. Furthermore, once it is revealed that a woman has not been circumcised, other circumcised girls will no longer associate with her. The pressure to undergo the procedure is immense; women who refuse what is socially expected are often isolated, ostracized, and prohibited from marriage (Braddy, 2007, p. 160). Moreover, an uncircumcised woman is often called derogatory names and denied access to roles that other adult women in the community are allowed to occupy. This in turn produces shame and embarrassment for those who will not undergo the process (Dorkenoo, 1994). In addition, many communities insist on the procedure occurring anywhere from two weeks after birth to toddlerhood, eliminating the possibility for a woman to make her own decision about the practice. In fact, it is assumed that her guardians or parents make the decision for her, which sheds light on the major limitation of the law criminalizing the practice.

Unfortunately, the laws preventing FGM do not hold the accomplices who help the FGM practition-er such as family and parents accountable, "therefore the parents that coerce their daughters to undergo the procedure are an instrumental force in the unrelenting prevalence of the procedure that continue to escape prosecution" (Irin News, 2004). Furthermore, Florence Ali, the president of the Ghanaian Association for Women's Welfare explains, "if these collaborators [such as families of the women] are left free, the traditional practices will continue" (Medical News Today, 2004). If a woman does not undergo FGM, it's likely that she will face public and private isolation, life without children or a husband, will be seen as dirty and unclean, and perhaps not even acknowledged as a woman by her own culture. Although it might be tempting for one to conclude that FGM is a detrimental practice that must be swiftly eradicated, it is apparent that difference cultures have different ways of perceiving the practice. It is only through understanding the cultural significance of FGM that advocacy groups will be able to make any progress in asking women to reconsider their decision to practice FGM. Perhaps in order to improve the current situation, instead of merely providing education on the possible risks of the procedure, advocacy groups should offer a more egalitarian approach in discussing the cultural foundations of FGM. Perhaps advocacy groups need to relinquish their control as the "experts" and in turn, allow those who have undergone the procedure to play a more active role in unmasking the complicated controversies of the situation. It is only through understanding the complex underlying cultural, social, and psychological factors involved that a sustained change can be developed and be beneficial for all parties.

References

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Ankomah, A. (2010). Ghana: Adolescents. International Encyclopedia of Sexuality. Retrieved from: http://www2.huberlin.de/sexology/IES/ghana.html

Assaad, M.B. (1980). Female circumcision in Egypt: social implications, current research, and prospects for change. Studies in Family Planning, 11(1), 3-16.

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Toubia, N. (1994).Female circumcision as a public health issue. The New England Journal of Medicine, 331, 712-716.

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