Sexual and reproductive health

Classification of female genital mutilation

Female genital mutilation has no known health benefits. On the contrary, it is known to be harmful to girls and women in many ways. First and foremost, it is painful and traumatic. The removal of or damage to healthy, normal genital tissue interferes with the natural functioning of the body and can cause several immediate and long-term health consequences. For example, FGM can cause excessive bleeding, swelling of genital tissue and problems urinating, and severe infections that can lead to shock and in some cases, death, as well as complications in childbirth and increased risk of perinatal deaths.

Eliminating female genital mutilation

cover interagency statement on fgm

An interagency statement - OHCHR, UNAIDS, UNDP, UNECA, UNESCO, UNFPA, UNHCR, UNICEF, UNIFEM, WHO

Communities that practice female genital mutilation report a variety of sociocultural reasons for continuing with it. Seen from a human rights perspective, the practice reflects deep-rooted inequality between the sexes, and constitutes an extreme form of discrimination against women.

Female genital mutilation is nearly always carried out on minors and is therefore a violation of the rights of the child. The practice also violates the rights to health, security and physical integrity of the person, the right to be free from torture and cruel, inhuman or degrading treatment, and the right to life when the procedure results in death.

Classification of FGM (2007)

Female genital mutilation comprises all procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs for non-medical reasons (WHO, UNICEF, UNFPA, 1997).

The WHO/UNICEF/UNFPA Joint Statement classified female genital mutilation into four types. Experience with using this classification over the past decade has revealed the need to sub-divide these categories to capture more closely the variety of procedures.

Although the extent of genital tissue cutting generally increases from Type I to III, there are exceptions. Severity and risk are closely related to the anatomical extent of the cutting, including both the type of FGM performed and the amount of tissue that is cut, which may vary between the types.

Type IV comprises a variety of practices that do not involve removal of tissue from the genitals. Though limited research has been carried out on Type IV FGM, in general, these forms appear to be less associated with harm or risk than the types I, II and III, that all involve removal of genital tissue.

The complete typology with sub-divisions is described below:

  • Type I — Partial or total removal of the clitoris and/or the prepuce (clitoridectomy). When it is important to distinguish between the major variations of Type I mutilation, the following subdivisions are proposed:
    • Type Ia, removal of the clitoral hood or prepuce only;
    • Type Ib, removal of the clitoris with the prepuce.
  • Type II — Partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora (excision). When it is important to distinguish between the major variations that have been documented, the following subdivisions are proposed:
    • Type IIa, removal of the labia minora only;
    • Type IIb, partial or total removal of the clitoris and the labia minora;
    • Type IIc, partial or total removal of the clitoris, the labia minora and the labia majora.
  • Type III — Narrowing of the vaginal orifice with creation of a covering seal by cutting and appositioning the labia minora and/or the labia majora, with or without excision of the clitoris (infibulation). When it is important to distinguish between variations in infibulations, the following subdivisions are proposed:
    • Type IIIa, removal and apposition of the labia minora;
    • Type IIIb, removal and apposition of the labia majora.
  • Type IV — All other harmful procedures to the female genitalia for non-medical purposes, for example: pricking, piercing, incising, scraping and cauterization.

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