International Day of Zero Tolerance to Female Genital Mutilation: Mental Health Implications

 

Every Febuary 6th is the  International Day of Zero Tolerance. The 2017 Theme is : "Building a solid and interactive bridge between Africa and the world to accelerate ending FGM by 2030."

Female Genital Mutilation (FGM) also known as female circumcision comprises all procedures that involve altering or injuring the female genitalia for non-medical. It involves removal of the clitoris and labia and the sewing up of the vagina, leaving only a small opening for urine and menstrual blood – a process known as infibulations, removal of the tip of the clitoris, total removal of the clitoris and surrounding labials an intentional way to alter or cause injury to the female genital organs (World Health Organization, WHO).

The practice has affected women and girls in 29 countries in sub-Saharan Africa, the Middle East, Asia and some ethnic groups in South America. Moreover, growing migration has increased the number of girls and women living outside their country of origin who have undergone FGM or who may be at risk of being subjected to the practice in Europe, Australia and North America. It is constantly evolving, hence prolonging its existence even as it raises many question as to why those who do it, do, despite a world of evidence to show that it is harmful.

The prevalence varies with countries, religion and ethnicity in Nigeria; FGM is prevalent in 31% of Catholics, 27% of Protestant and 7% of Muslim women (UNICEF, 2010). FGM was banned throughout the country in 2015(Guardian Retrieved, Reuters. com, 2000 & 2015). Over 80% of all FGMs are performed on girls under one year of age. It is estimated that 7.9 million women and girls in Tanzania have undergone FGM.

Credits: Dailynews Egypt

Social norms, customs and values have fueled this practice. The desire for social acceptance and avoidance of social stigma is the single largest factor influencing the continuation of FGM (2016 report of the UN Secretary-General). It reflects deep-rooted inequality between the sexes, and constitutes an extreme form of discrimination against women and girls. The practice also violates their rights to health, security and physical integrity, their right to be free from torture and cruel, inhuman or degrading treatment, and their right to life when the procedure results in death. What about the long term psychological effects?

Key Facts

• Globally, it is estimated that at least 200 million girls and women alive today have undergone some form of FGM.
• Girls 14 and younger represent 44 million of those who have been cut, with the highest prevalence of FGM among this age in Gambia at 56 per cent, Mauritania 54 per cent and Indonesia where around half of girls aged 11 and younger have undergone the practice.
• Countries with the highest prevalence among girls and women aged 15 to 49 are Somalia 98 per cent, Guinea 97 per cent and Djibouti 93 per cent.
• FGM is mostly carried out on young girls sometime between infancy and age 15.
• FGM cause severe bleeding and health issues including cysts, infections, infertility as well as complications in childbirth increased risk of newborn deaths.
• FGM is a violation of the human rights of girls and women.
• The Sustainable Development Goals in 2015 calls for an end to FGM by 2030 under Goal 5 on Gender Equality, Target 5.3 Eliminate all harmful practices, such as child, early and forced marriage and female genital mutilation.
• The elimination of FGM has been called for by numerous inter-governmental organizations, including the African Union, the European Union and the Organization of Islamic Cooperation, as well as in three resolutions of the United Nations General Assembly.

Psychological Effects of FGM

• Chronic pain syndrome
• Shock
• Post Traumatic Stress Disorder (PTSD)
• Depression
• Sleep disordersand somatization.
•  Reduced social/ isolation functioning, worthlessness and guilt
•  Suicidal ideation.

Immediate psychological trauma may stem from the pain, shock and the use of physical force by those performing FGM (WGO, 2006). In the long term, post-traumatic stress disorder (PTSD), anxiety, depression and memory loss may occur (Behrendt and Moritz, 2005). A study in practicing African communities found that women who have undergone FGM have the same levels of Post Traumatic Stress Disorder (PTSD) as adults who have been subjected to early childhood abuse, and that the majority of the women (80 per cent) suffer from affective (mood) or anxiety disorders (Keel, 2014, p.6).
 
Women who have undergone FGM may also be affected by chronic pain syndrome, and as with other causes of chronic pain there is an increased risk of depressed mood, with reduced social functioning, worthlessness, guilt, and even suicidal ideation. Limited mobility also increases social isolation and role loss in society (Whitehorn, Ayonrinde and Maingay, 2002, p.166).

Burrage (2015, p.99) writes that women who have experienced FGM tend to develop psychological conditions which make them withdrawn and uncommunicative or distrustful. There are anecdotal reports of teenage girls ‘returning to the UK from “holidays” abroad who were well adjusted to school before they went, but who fail to thrive in the learning environment after they return’ (p.99). Other psychological effects include emotional distance, flashbacks, sleep disorders, social isolation, and somatization.

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