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Culture, Gender, Health Care, Health Disparities, Healthcare, Public Health, Public Policy, Reproductive Rights, Social Justice, Society, Uncategorized, Women's Health, Women's Rights

The Growing Epidemic Of Female Genital Mutilation In America

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The number of women and girls at risk for female genital mutilation (FGM) in the United States has more than doubled in the past 10 years, according to new figures released on Friday. The data, the first on FGM in the U.S. for a decade, was published to coincide with the United Nations’ International Day of Zero Tolerance for FGM.

More than half a million women and girls in the U.S. are at risk of undergoing FGM in the U.S. or abroad, or have already undergone the procedure, including 166,173 under the age of 18, according to the Population Reference Bureau (PRB). Immigration to the U.S. from African and Middle Eastern countries—where the practice of FGM is a deeply entrenched cultural tradition—is cited as the primary factor behind the rise in numbers.

The PRB investigation found that New York City and Washington, DC were the cities with the highest number of women impacted by FGB, with at least 50,000 females at risk in both. Minneapolis came in third based on its high Somali population.

According to the Guardian, unpublished data from the US Centers for Disease Control (CDC) and Prevention reveals that the number of females living with or at risk of FGM has gone up to 513,000 from 168,000 in 1997, mirroring PRB’s estimate. The CDC was going to publicly release the figures on Friday, the 12th annual International Day of Zero Tolerance to FGM. The report was held, though, to finalize its preparation.

The 168,000 estimate in 1997 was based on the most-recent US Census data available at the time, from 1990. In 2000, the African Women’s Center reported that 227,000 women were at risk or living with FGM ramifications, according to the Daily Beast.

“There are many more girls and women at risk of FGM than there were a decade ago, by the very nature of immigration coming from countries where it is carried out,” Charlotte Feldman-Jacobs, PRB’s program director for gender, told the Guardian.

“It’s very important to have these figures. Yes, there are laws in place but are we meeting the health needs of these women and girls? [These figures show] FGM is happening in New York, in Boston, it really brings it home that this is not just something that happens over there.”

A ‘ritual form of child abuse and violence against women’

Included in the data are girls at risk of being sent back to their family’s origin country to undergo FGM—a practice widely known as “vacation cutting”—or having a traditional midwife or cutter sent to perform FGM in the U.S.

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Globally, around 130 million women and girls are living with the effects from FGM and around 3 million undergo the procedure annually, according to the United Nations Population Fund (UNFPA). The practice, known to be performed on a widespread in at least 29 countries, involves cutting the external female genitalia for non-medical reasons. Depending on local customs, it could also include additional modifications ranging from cutting away part of the clitoris to removing the inner and outer vaginal lips before sewing the remaining skin together, leaving a small hole for urination and menstrual blood.

The procedure — carried out for traditional, patriarchal purposes of control over female sexuality — is often done under unsanitary conditions by someone without sufficient medical or anatomical knowledge. Typically, it is also performed without any anesthesia or other pain relief. Indeed, the pain is considered part of the centuries-old ritual — to prove that the woman is strong and can endure it. Corrosive substances may also be inserted into the vagina to scar, tighten and narrow it.

In societies where FGM is commonplace, a woman can bring shame on herself and her family if she does not comply. Some see it as a religious necessity – though no scriptures actually prescribe it. There are no legitimate medical reasons for performing the procedure, and many risks are associated with FGM even when it is done in a hygienic setting. An obvious one is severe pain – both physical and psychological. Victims recall fighting to get free as they were held down and their legs forcibly spread for the cutting. Some women die from the procedure, while others suffer a lifetime of devastating complication from severe infections, to pain and bleeding, and even a higher risk of death during childbirth.

Tools used to perform FGM are often unsanitary and can cause serious infections, disfigurement, and long-term physical and psychological pain.

Tools used to perform FGM (pictured above) are often unsanitary and can cause serious infections, disfigurement, and long-term physical and psychological pain.

“Despite these grave risks, its practitioners look on it as an integral part of their cultural and ethnic identity, and some perceive it as a religious obligation,” reports the Guttmacher Institute. “Opponents of female genital cutting, however, emphasize that the practice is detrimental to women’s health and well-being. Some consider female circumcision a ritualized form of child abuse and violence against women, a violation of human rights.”

The number of FGM cases can only be called an estimate since the practice is done in strict secrecy, as it is a felony in the US to admit to organizing a cutting. Feldman-Jacobs told the Daily Beast that FGM data must improve for the issue to receive proper attention.

“How can we get better data?” she said. “We need to find out more about where they come from because if you look at maps on FGM, it’s not from all parts of all countries. If you take, for instance, the north of a particular country, it may have a 100 percent FGM rate, while another region of the same country has zero. So assuming a girl [from that country] has 100 percent been cut may be incorrect.”

Saving women and girls from the horrors of FGM

PRB’s findings come at a time of heightened awareness and concern about FGM in countries across the world. In Egypt, where the practice is illegal, a doctor named Raslan Fadl was sentenced to two years in prison for manslaughter in January for performing an FGM operation that killed 13-year-old Sohair al-Batea in 2013. This was the country’s first FGM conviction. The U.K. also had its first-ever FGM trial this year, but Dr. Dhanuson Dharmasena, who was accused of illegally performing FGM on a woman in London days after she gave birth, was acquitted on Wednesday.

While the global prevalence of FGM has fallen in recent years, the risk for girls in the U.S. is on the rise.

While the global prevalence of FGM has fallen in recent years, there has been an increase in the U.S., where an estimated 500,00 girls and women at risk.

Immigration to Western countries where FGM is not traditionally practiced means health care providers have had to adapt to the harmful medical consequences of FGM. Greater awareness, along with better outcome data—last month, Heartlands Hospital in Birmingham, U.K., reported treating 1,500 cases of FGM in the past five years—has led to acknowledgement of the specialized health care needs of women have had FGM, like psychological trauma and greater attention during childbirth due to pain, possible genital tears and the danger posed to the unborn child.

FGM has been illegal in the U.S. since 1996 and twenty-two US states have instituted their own anti-FGM laws. However, an amendment to the law banning vacation cutting wasn’t passed until 2012.  In 2006, Khalid Adem, an Ethiopian immigrant, was the first person convicted of performing FGM in the U.S. after prosecutors alleged he cut his daughter’s clitoris with a pair of scissors.

On Thursday, U.S. Rep. Joe Crowley of New York and U.S. Rep. Sheila Jackson Lee of Texas, both Democrats, introduced the Zero Tolerance for FGM Act of 2015, which would charge the federal government with drafting and implementing a national strategy to protect girls in the United States from FGM. Among other things, the new bill is expected to establish a hotline for at-risk girls and better education for teachers, health care workers, and law enforcement.

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