Sexual and reproductive health

Female genital mutilation and other harmful practices

FGM and sexuality

Though a link between FGM and control of women's sexuality has been frequently described, there have been few rigorous studies investigating the significance of perceptions of women's sexuality with regard to the continuation or abandonment of FGM. In 2006, WHO issued a call for proposals that yielded more than 30 concept papers. Three of these studies were selected for funding. This included two studies in Senegal and one in Egypt, all using explorative, qualitative methods. The studies were completed in 2009. For a summary of the findings from each study, please see the policy brief below.

Some findings

Sexual control

FGM was closely associated with sexual control in all three studies. The clitoris was understood as a site for sexual urge, hence it was believed that cutting it would curb women's natural sexual urge and thereby increase their ability to remain a virgin prior to marriage, and to remain faithful and not too demanding within marriage.

Sexual pleasure

Most informants did not believe FGM reduced women's pleasure during sexual relations. However, there was a growing concern among the younger generation, particularly the men, that this could be the case, and that this could have a negative effect on their own sexual pleasure. However, in Egypt, expression of sexual desire or pleasure from women was generally not considered appropriate.

Belief that FGM is "medically necessary or beneficial"

In Egypt there was a concern over the size of the clitoris, and it was a general consideration that a majority of women "needed" FGM, as their clitoris was considered too large. A large clitoris was feared to stimulate sexual desire. Also, in both countries, there was a frequent belief that the clitoris could become infected with worms if not cut, and that this could have a negative health effect on girls.

Type of FGM

It was found that a type of infibulation, generally referred to as "sealing", was common in some areas of Senegal. This was infibulation in the form of Type IIIa, in which adhesion is achieved between the labia minora. These findings concur with findings from the decision-making study that documented a prevalence of 15% in women and 13% in their daughters. Also, the WHO study of obstetric outcome of FGM in six African countries reported a high prevalence of Type IIIa (13%) among women giving birth in Burkina Faso. This type was again closely associated with virginity.