tag:theconversation.com,2011:/fr/topics/female-genital-mutilation-5899/articlesFemale genital mutilation – The Conversation2024-03-28T15:09:02Ztag:theconversation.com,2011:article/2266322024-03-28T15:09:02Z2024-03-28T15:09:02ZThe Gambia may allow female genital mutilation again – another sign of a global trend eroding women’s rights<p>The Gambia’s ban on <a href="https://africlaw.com/2016/01/19/banning-female-circumcision-in-the-gambia-through-legislative-change-the-next-steps/">female genital mutilation (FGM)</a> since 2015 is <a href="https://africlaw.com/2024/03/22/threats-to-endfgm-law-in-the-gambia/#more/-3155">under threat</a>. Proposed changes before parliament could permit <a href="https://obgyn.onlinelibrary.wiley.com/doi/full/10.1002/ijgo.12792">medicalised</a> female genital cutting and allow it for consenting adults. </p>
<p>This potential reversal has thrust the country into the <a href="https://www.theguardian.com/global-development/2024/mar/18/move-to-overturn-fgm-ban-in-the-gambia-postponed">global spotlight</a> as the latest example of the backlash against gender equality.</p>
<p>The Gambia’s criminalisation of FGM was not the first in west Africa but it came as a surprise. The president at the time, Yahya Jammeh, declared the <a href="https://gambia.unfpa.org/sites/default/files/pub-pdf/national_policy_for_the_elimination_of_fgm.pdf">rampant cultural tradition</a> a non-religious practice that caused harm. There was some dissent within the country but human rights groups <a href="https://apnews.com/general-news-9fb847c01f8e448c97f5d09b8a844cba">welcomed</a> the ban. </p>
<p>Jammeh, who was president from 1994 to 2016, also oversaw the passage of other progressive gender-related laws. The <a href="https://www.lawhubgambia.com/domestic-violence-act-2013">Domestic Violence Act 2013</a> provided a framework for combating domestic violence in all its forms (physical, sexual, emotional, economic) and protection in particular for women and children. The <a href="https://www.lawhubgambia.com/sexual-offences-act-2013">Sexual Offences Act 2013</a> expanded the definition of rape, broadened the circumstances in which individuals could be charged, and reduced the burden of proof in prosecutions.</p>
<p>Jammeh also <a href="https://security-legislation.gm/wp-content/uploads/2022/10/Childrens-Amendment-Act-2016.pdf">outlawed</a> child marriages in 2016. This was significant in country where <a href="https://dhsprogram.com/pubs/pdf/FR369/FR369.pdf">one in five young people aged 15-19 (19%)</a> are married. </p>
<p>In <a href="https://www.euractiv.com/section/development-policy/news/eu-cuts-aid-to-gambia-over-human-rights-concerns/">one of the world’s most aid-dependent countries</a>, these reforms were all central to international donor interests. And they helped to improve the country’s democratic reputation. But at the same time, they made it easy for the <a href="https://www.jstor.org/stable/48609039">autocratic</a> leader to get away with other excesses. He also mobilised religion to manipulate beliefs and sentiments, particularly affecting girls and women. For example, Jammeh <a href="https://www.theguardian.com/world/2016/jan/05/gambia-female-government-workers-headscarves-islamic-republic">mandated</a> that female government workers wear veils or headscarves when he declared his <a href="https://www.researchgate.net/publication/353945890_2020_Religious_Tolerance_in_the_Gambia">Muslim majority</a> country an Islamic state in 2016. </p>
<p>President Adama Barrow, Jammeh’s successor, has emphasised religious tolerance and has refrained from employing religious symbolism. Unlike the state-sponsored homophobia under the Jammeh regime, Barrow has downplayed homosexuality as a <a href="https://www.pulp.up.ac.za/edocman/edited_collections/queer_lawfare_in_africa/Chapter%2011.pdf">“non-issue”</a>.</p>
<p>I am a legal scholar and human rights practitioner with published research on <a href="https://scholar.google.com/citations?view_op=view_citation&hl=en&user=Q0j-E18AAAAJ&citation_for_view=Q0j-E18AAAAJ:u5HHmVD_uO8C">female genital mutilation</a>, <a href="https://scholar.google.com/citations?view_op=view_citation&hl=en&user=Q0j-E18AAAAJ&citation_for_view=Q0j-E18AAAAJ:zYLM7Y9cAGgC">gender equality and women’s rights</a> and <a href="https://scholar.google.com/citations?view_op=view_citation&hl=en&user=Q0j-E18AAAAJ&citation_for_view=Q0j-E18AAAAJ:_kc_bZDykSQC">governance</a> in The Gambia. It’s my view that Jammeh’s ostensible compliance with gender equality norms was selective and intended for the international gallery rather than a genuine commitment to women’s rights and democracy.</p>
<p>His tactical stance highlighted a broader trend. Autocratic African leaders often accommodate global gender norms to maintain domestic power dynamics. The result, for example, is <a href="https://journals.sagepub.com/doi/full/10.1177/00104140221074277">increased women’s political participation through quotas</a> along with a conservative approach to sexual and reproductive health and rights.</p>
<p>The Gambia experience also shows that western donors and multilateral institutions need to go beyond just pushing for reforms. Once they have got the reforms they advocated for, they should have a strategy for sustaining them. Forces that were opposed to the reform often regroup to campaign for its removal. </p>
<p>At its core, female genital mutilation <a href="https://www.pulp.up.ac.za/edocman/pulp_commentaries/protocol_to_ACHPR/Article_5.pdf">constitutes</a> a <a href="https://obgyn.onlinelibrary.wiley.com/doi/10.1002/ijgo.12792">violation</a> of the human rights of girls and women. These include the right to non-discrimination, to protection from physical and mental violence, and to health and life. </p>
<p>From a feminist perspective, the prevalence of FGM in numerous African nations revolves around upholding gender-specific norms and exerting control over women’s sexuality.</p>
<h2>Female genital mutilation in The Gambia</h2>
<p>Female genital cutting is a <a href="https://gambia.unfpa.org/sites/default/files/pub-pdf/national_policy_for_the_elimination_of_fgm.pdf">deeply ingrained practice</a>. It is driven by cultural beliefs and often performed by traditional healers. According to the most recent <a href="https://dhsprogram.com/publications/publication-FR369-DHS-Final-Reports.cfm">national survey</a>, a large majority of Gambian women aged 15-49 years (73%) have undergone female genital cutting. More alarming is an <a href="https://www.unicef.org/gambia/media/776/file/The%20Gambia%20Multiple%20Indicator%20Cluster%20Survey%202018.pdf">8% increase in the prevalence</a> of FGM among girls under the age of 14 – from 42.4% in 2010 to 50.6% in 2018. </p>
<p>Numerous health risks associated with all types of the practice have been documented by the <a href="https://www.who.int/en/news-room/fact-sheets/detail/female-genital-mutilation">World Health Organization</a> and <a href="https://gh.bmj.com/content/2/4/bmjgh-2017-000467#ref-5">systematic reviews</a>. These include severe pain, bleeding, infections and complications during childbirth and elevated rates of anxiety and other mental health disorders. This has led to <a href="https://eyala.blog/my-musings/repealing-the-endfgm-law-will-be-a-betrayal-of-women-and-girls-in-the-gambia-jama-jack">calls</a> for the practice to be banned in order to protect girls’ health and well-being.</p>
<p>The Gambia’s current struggle with the FGM ban reflects a complex interplay between cultural norms, religious beliefs, and the fight for gender equality. The potential repeal of the ban poses a threat to human rights of women and girls in The Gambia.</p>
<h2>Reversal of hard-won gains</h2>
<p>Though The Gambia is constitutionally secular, religion influences nearly every facet of society. Islamic fundamentalists in the country are known for attacks on religious minorities, including <a href="https://malagen.org/media-monitoring/hate-speech-alert-imam-fatty-attacks-ahmadis/">hate speech</a> against the Ahmadiyya Muslim community and the <a href="https://www.voicegambia.com/2023/05/11/rising-religious-tension-in-the-country/">Christian community</a>. </p>
<p>The main fundamentalist religious actors draw inspiration from and still support the exiled former dictator Jammeh. They are at the forefront of the <a href="https://africlaw.com/2024/03/22/threats-to-endfgm-law-in-the-gambia/#more-3155.">recent pushback</a> against the anti-FGM law. They argue that the ban violates their religious and cultural freedoms as guaranteed in the <a href="https://www.lawhubgambia.com/1997-constitution">1997 constitution</a>. </p>
<p>On 4 March 2024 a <a href="https://standard.gm/nam-to-seek-power-of-attorney-from-jammeh-to-sue-govt/">strong supporter of Jammeh</a> proposed a private member’s <a href="https://satangnabaneh.com/contesting-the-prohibition-of-female-genital-mutilation-in-the-gambia/">bill</a> in the National Assembly that seeks to overturn the ban.</p>
<p>The push to reassert traditional gender roles isn’t isolated to The Gambia. There is a global trend of rolling back progress on gender equality. This trend is characterised by attempts to limit <a href="https://www.pulp.up.ac.za/emerging-voices-series/choice-and-conscience-lessons-from-south-africa-for-a-global-debate">women’s bodily choices</a>, an <a href="https://www.ohchr.org/sites/default/files/Documents/Issues/Women/WG/Gender-equality-and-gender-backlash.pdf">increase in violence</a> against them, as well as <a href="https://www.pulp.up.ac.za/edited-collections/queer-lawfare-in-africa-legal-strategies-in-contexts-of-lgbtiq-criminalisation-and-politicisation">attacks</a> on LGBTQI+ communities. It reflects a broader political climate of backlash against women’s rights and gender equality as a weapon in the reversal of democratic achievements.</p>
<p>Attempts have been seen to reverse legal protections against women and girls in <a href="https://au.int/en/articles/kenyas-court-ruling-against-fgm-demonstrates-commitment-member-states-shun-practices">Kenya</a>. In Sudan, state-sanctioned violence and societal pressure is aimed at <a href="https://africanarguments.org/2019/07/against-laws-regime-sudan-women-protesters-want/">restricting</a> women’s public participation. Similarly, Tanzania previously enacted a policy barring teenage mothers from <a href="https://www.moe.go.tz/sw/nyaraka/waraka-wa-elimu-na-2-wa-mwaka-2021-kuhusu-kuingia-tena-shule-kwa-wanafunzi-wa-shule-za">attending</a> public schools, though this policy has been reversed. </p>
<p>This global context highlights how anti-rights movements, undemocratic norms and gendered politics are working together to erode women’s rights and exacerbate inequalities.</p><img src="https://counter.theconversation.com/content/226632/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Satang Nabaneh does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>The potential repeal of the ban on female genital mutilation poses a threat to the well-being of girls in The Gambia.Satang Nabaneh, Director of Programs, University of DaytonLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2105492023-09-13T02:12:08Z2023-09-13T02:12:08ZFemale genital cutting remains a taboo subject in Pakistan, preventing real progress from being made<figure><img src="https://images.theconversation.com/files/547151/original/file-20230908-15-8gkxww.jpg?ixlib=rb-1.1.0&rect=291%2C50%2C5834%2C4416&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Shutterstock</span></span></figcaption></figure><p>Female genital cutting is a <a href="https://www.jogc.com/article/S1701-2163(17)30691-6/fulltext">secretive</a> and largely invisible practice in Pakistan. </p>
<p>The experiences of <a href="https://www.youtube.com/watch?v=htp-s8QvToE">survivors</a> are the only sources of information we have to understand its prevalence. There are no national statistics or governmental efforts to counter the practice or this <a href="https://www.refworld.org/docid/4f0ac6bc2.html">lack of awareness</a>. Open conversations are difficult because women’s bodies are treated as a source of <a href="https://broadview.org/fgm-canada-dawoodi-bohra/">shame or taboo</a>. </p>
<p>My <a href="https://vc.bridgew.edu/jiws/vol24/iss1/18/">research</a> has found we must understand female genital cutting from a Pakistani perspective and work towards bridging the knowledge gap through increased data collection and encouraging greater dialogue with survivors. </p>
<p>Otherwise, Pakistan risks being left behind in achieving one of the United Nations’ <a href="https://www.unwomen.org/en/node/36060#:%7E:text=Eliminate%20all%20harmful%20practices%2C%20such,marriage%20and%20female%20genital%20mutilation">sustainable development goals</a>, the elimination of female genital cutting by 2030.</p>
<h2>What is female genital cutting?</h2>
<p>There are <a href="https://www.who.int/news-room/fact-sheets/detail/female-genital-mutilation">four types</a> of female genital cutting, but generally speaking, it involves
the <a href="https://www.who.int/teams/sexual-and-reproductive-health-and-research-(srh)/areas-of-work/female-genital-mutilation/types-of-female-genital-mutilation">partial or total removal</a> of the external female genitalia. This can be through pricking, scraping, stitching and burning. </p>
<p>At least <a href="https://data.unicef.org/topic/child-protection/female-genital-mutilation/">200 million girls and women</a> globally have experienced different forms of female genital cutting, according to the United Nations. It is practised on <a href="https://www.unfpa.org/resources/female-genital-mutilation-fgm-frequently-asked-questions#where_practiced">every continent</a>, except <a href="https://www.aljazeera.com/opinions/2017/10/5/fgm-a-native-affliction-on-every-inhabitable-continent">Antarctica</a>. </p>
<p>A small minority of <a href="https://www.thedawoodibohras.com/about-the-bohras/">Dawoodi Bohra Muslims</a> from the Shiite Ismaili sect practice female genital cutting in Pakistan (as well as in India). </p>
<p>The practice also occurs within the Dawoodi Bohra <a href="https://www.npr.org/sections/goatsandsoda/2018/02/28/589173639/a-secretive-sect-opens-a-debate-on-female-genital-mutilation">diaspora</a>. In 2015, a mother, nurse and spiritual leader were found guilty in Australia’s first genital mutilation <a href="https://www.theguardian.com/society/2015/nov/13/female-genital-mutilation-trial-young-girl-convinced-jury-australia">trial</a>. Even though the practice is illegal in Australia, it is <a href="https://www.watoday.com.au/national/western-australia/how-covid-19-borders-drove-perth-family-to-seek-female-genital-mutilation-on-home-soil-20211117-p599tv.html">still carried out in secret</a>.</p>
<p>Dawoodi Bohras generally practice a type of cutting called <em>khatna</em>, or the removal of the clitoral hood. Young girls usually undergo this practice at <a href="https://www.orchidproject.org/about-fgc/where-does-fgc-happen/pakistan/">seven years old</a>. This is ostensibly done to curb a <a href="https://sahiyo.org/images/D16.pdf">woman’s sexual desire</a>, to promote <a href="https://sahiyo.org/sahiyo-blog/why-do-dawoodi-bohras-practice-khatna.html">genital hygiene</a> and to follow the Islamic <a href="https://www.unfpa.org/sites/default/files/pub-pdf/De-linking%20FGM%20from%20Islam%20final%20report.pdf"><em>sunnah</em></a>, or the <a href="https://www.bbc.co.uk/bitesize/guides/zj36gwx/revision/2">sayings and practices</a> of the Prophet Muhammad. </p>
<p>Religious <a href="https://www.ghanaweb.com/GhanaHomePage/NewsArchive/Islam-does-not-support-female-circumcision-Expert-77396">scholars</a>, medical <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8260090/">practitioners</a> and <a href="https://sahiyo.org/sahiyo-blog/what-islam-says-part-1.html">activist organisations</a> argue, however, that it is a harmful practice and not a religious duty. </p>
<p>According to World Health Organization, there are short-term and long-term health <a href="https://www.who.int/teams/sexual-and-reproductive-health-and-research-(srh)/areas-of-work/female-genital-mutilation/health-risks-of-female-genital-mutilation">risks</a> from the practice. These include severe pain, bleeding, infections, urination problems, obstetric fistulas, perinatal risk, trauma and other mental health problems. <a href="https://www.news18.com/news/india/with-no-laws-india-a-hub-for-female-genital-mutilation-on-expats-foreigners-report-1651551.html">A study in India</a> also reported side effects such as low sex drive, oversensitivity in the clitoral area and problems with sexual pleasure and trusting partners. </p>
<p>While there are members of the Dawoodi Bohra community who speak out against the practice, some also defend it as a <a href="https://bristoluniversitypressdigital.com/view/journals/gd/12/1/article-p9.xml">cultural right</a>. Most Dawoodi Bohras are secretive about it due to a fear of potential backlash, since acts of violence against minorities are common in Pakistan. </p>
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Read more:
<a href="https://theconversation.com/why-its-so-difficult-to-end-female-genital-mutilation-131162">Why it's so difficult to end female genital mutilation</a>
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<h2>Not just an African problem</h2>
<p>Most international efforts to eliminate female genital cutting focus on Africa. As a result, it is believed to be an African practice. </p>
<p>Somalia has one of the <a href="https://africa.unwomen.org/en/stories/news/2022/05/from-knowledge-to-action-ending-female-genital-mutilation-in-somalia">highest prevalence rates</a> of female genital mutilation in the world, with 99% of women aged 15-49 having been cut. Sudan also saw an increase in the practice during COVID lockdowns, despite it being <a href="https://reliefweb.int/report/world/eighty-cent-fgm-cases-happen-africa">criminalised in 2020</a>. </p>
<p>This <a href="https://data.worldbank.org/indicator/SH.STA.FGMS.ZS?locations=ZG">statistical data</a> is available to us because African countries are able to measure its prevalence through nationally representative household surveys. <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0238782">Self-reporting</a> is also used to acquire data from mothers and daughters. </p>
<p>Although these data collection efforts are not always <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0238782">reliable</a>, the general level of awareness in some African countries gives activists and policymakers a platform to organise more targeted <a href="https://www.globalcitizen.org/en/content/5-activists-fighting-fgm-in-africa/">campaigns</a> to bring social change. </p>
<p>Research shows the practice is also <a href="https://theprint.in/opinion/modi-govt-in-denial-about-female-genital-mutilation-in-india-collect-data-let-states-ban-it/1230724/">widespread</a> among the Dawoodi Bohra community in India. The Indian government, however, has <a href="https://www.csmonitor.com/World/Asia-South-Central/2023/0209/Is-there-female-genital-mutilation-in-India-Delhi-says-no-survivors-say-yes">denied</a> the existence of female genital cutting in the country, meaning there is no official data collection there, either. </p>
<p>However, in 2017, a <a href="https://lawschoolpolicyreview.com/2022/12/21/examining-the-constitutionality-of-female-genital-mutilation-in-india/">human rights advocate</a> and lawyer filed a petition before the Supreme Court to <a href="https://indiankanoon.org/doc/181206322/">ban the practice</a>. Although a decision is still <a href="https://blogs.lse.ac.uk/humanrights/2022/05/06/female-genital-mutilation-cutting-in-india-an-urgent-need-for-intervention/">pending</a>, <a href="https://www.mid-day.com/mumbai/mumbai-news/article/sunita-tiwari-lawyer-pil-female-genital-mutilation-interview-bohra-community-khatna-18300161">non-profit organisations</a> continue to speak out against the practice. </p>
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<h2>What can be done in Pakistan?</h2>
<p>Pakistan ranks as <a href="https://www.dawn.com/news/1760949#:%7E:text=Pakistan%20ranks%20142%20out%20of%20146%20countries%20in%20WEF's%20global%20gender%20gap%20report,-Amin%20Ahmed%20Published&text=Screengrab%20taken%20from%20WEF's%20report.&text=In%20the%20World%20Economic%20Foru">142nd out of 146 countries</a> in the <a href="https://www3.weforum.org/docs/WEF_GGGR_2023.pdf">Global Gender Gap report 2023</a> by the World Economic Forum. It is frequently criticised by human rights activists for its high rates of <a href="https://unwatch.org/pakistan-claims-stellar-human-rights-record-ahead-of-mondays-un-review/">violence against women and mistreatment of minorities</a>. </p>
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<p>Recently, there has been more activism in Pakistan against <a href="https://tribune.com.pk/story/2382670/civil-society-protest-against-honour-killing">honour killings of women</a>, the mistreatment of the <a href="https://www.voanews.com/a/activists-decry-pakistani-religious-court-s-transgender-law-decision-/7102005.html"><em>khwaja sira</em> (transgender) community</a> and <a href="https://www.thenews.com.pk/print/1096140-speakers-at-seminar-express-zero-tolerance-for-child-labour">child labour</a>. Protests and community engagement make these issues more visible and put pressure on the government to respond.</p>
<p>This is not the case with female genital cutting. To curb the practice in Pakistan, it must be openly addressed and understood. </p>
<p>How can we do this? Through responsible data collection and consensual conversations with community members. </p>
<p>Dialogue should start in the Dawoodi Bohra community because <a href="https://www.tandfonline.com/doi/abs/10.1080/01436597.2023.2178408">change from within</a> is more likely to be long-lasting and less contentious. Considering Pakistan’s fractious religious climate, it is important for communities to mobilise for change from within to avoid the Dawoodi Bohras being targeted in sectarian violence.</p>
<p>Religion and women’s bodies are sensitive topics in patriarchal societies. Pakistan’s history with women has long been marked by an urge to morally police their bodies. One discriminatory practice, the <a href="https://www.nytimes.com/2021/01/06/world/asia/pakistan-virginity-tests.html">two-finger virginity testing</a> in sexual assault cases, for example, has only recently been abolished after a concerted push from activists.</p>
<p>This is why an issue like female genital cutting must be discussed with contextual care and caution. This approach, supported by activists and lawmakers within the community, will be transformative in ending this practice for good.</p><img src="https://counter.theconversation.com/content/210549/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Huda Syyed does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Pakistan has no official indicators to measure female genital cutting and no laws against it. There are also rarely protests against it.Huda Syyed, PhD Candidate & Tutor, Charles Darwin UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2002942023-04-12T13:40:35Z2023-04-12T13:40:35ZOnly 1 in 3 girls makes it to secondary school in Senegal: here’s why and how to fix it<figure><img src="https://images.theconversation.com/files/519615/original/file-20230405-22-w162fj.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The reasons that explain why girls don’t get into secondary begin in primary school.
</span> <span class="attribution"><span class="source">Godong via Getty Images</span></span></figcaption></figure><p><em>Senegal has a <a href="https://www.ansd.sn/Indicateur/projections-demographiques">young population</a>, with about half of its 18 million people aged below 19. This indicates a potentially high demand for education. Of those aged six to 11, however, <a href="https://www.epdc.org/sites/default/files/documents/EPDC_NEP_2018_Senegal.pdf#page=1">41%</a> are out of school. In the age group 12 to 18, <a href="https://www.epdc.org/sites/default/files/documents/EPDC_NEP_2018_Senegal.pdf#page=1">43%</a> aren’t in school. <a href="https://www.education.sn/sites/default/files/2019-08/RNSE%20_2018%20%20-DPRE_DSP_BSS-%20vf%20juillet%202019.pdf#page=64">Statistics show</a>, too, that the enrolment numbers of girls decrease as they advance in grades. To understand these dynamics, the African Population and Health Research Center <a href="https://aphrc.org/publication/the-state-of-education-and-implications-of-srhr-on-the-education-of-adolescent-girls-in-senegal/">carried out a two-year study</a> on girls’ education and wellbeing in Senegal. The Conversation Africa asked Benta A. Abuya, a lead researcher on the study, to unpack the findings.</em></p>
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<h2>You found that only <a href="https://aphrc.org/wp-content/uploads/2020/08/APHRC_The-State-of-Education_ENG-1.pdf#page=2">a third of girls</a> enrol in a secondary school. Why is this?</h2>
<p>The reasons begin in primary school. In Senegal, the official primary school entrance age is six. Primary school lasts six years, lower secondary lasts four years and upper secondary lasts three years.</p>
<p><a href="https://aphrc.org/wp-content/uploads/2020/08/APHRC_The-State-of-Education_ENG-1.pdf#page=47">Our findings</a> were that in the last grade of primary school, the dropout rate was 26.7% for girls and 22.2% for boys. </p>
<p>We found that financial hardship in households is one of the obstacles to girls and boys completing school. About <a href="https://www.wfp.org/countries/senegal">39%</a> of Senegalese live below the poverty line.</p>
<p>Despite the existence of <a href="https://www.consortiumeducation.org/sites/consortiumeducation/files/2021-11/LETTRE%20DE%20POLITIQUE%20GENERALE%20POUR%20LE%20SECTEUR%20DE%20L%E2%80%99EDUCATION%20ET%20DE%20LA%20FORMATION%20LPGS-EF.pdf">government programmes</a> - like free public school education until age 16 and the Girls’ Education Support Project, which provides school uniforms - the cost of schooling is still an obstacle for many families. They have to pay for learning materials and transport to school.</p>
<p>We also found a preference to educate boys over girls. In households with limited finances, boys are more likely to be sent to school even if girls would like to go.</p>
<p>Additionally, girls who are delinquent, lack interest in school or engage in unsafe sexual activities tend to be judged harshly by communities. They are viewed as bringing shame to their families. They are, therefore, withdrawn from school and married off early in an attempt to address this behaviour.</p>
<p>Deep-seated cultural beliefs and practices – such as female genital mutilation, forced child marriages and early pregnancies – also prevent some girls from making progress in school. They, therefore, lag in education and wellbeing. </p>
<p>The legal age of <a href="https://www.tandfonline.com/doi/pdf/10.1080/1554477X.2017.1375786">marriage in Senegal is 16 for girls and 18 for boys</a>. But families decide when girls get married. For example, in the Kolda region in the south, <a href="https://reproductive-health-journal.biomedcentral.com/articles/10.1186/s12978-021-01295-5">68% of girls get married before they turn 18</a>. This is more than double the national average of 31%.</p>
<p>In a scoping review we did in 2019, we found that out of 1,321 adolescent girls, <a href="https://www.jstor.org/stable/pdf/resrep28641.pdf?refreqid=excelsior%3A966c61f0bf91f2b2d091eee177c1417c&ab_segments=&origin=&initiator=&acceptTC=1">78% got pregnant between ages 12 and 18</a>. Of these pregnancies, 25.6% occurred before the girls turned 15. And in an <a href="https://aphrc.org/wp-content/uploads/2023/03/Rapport-IGE-english.pdf#page=10">exploratory study</a> we did in 2021, teenage pregnancy was predominantly cited in Zinguinchor and Sedhiou regions in south-west Senegal, as leading to girls dropping out of school. </p>
<p>Some girls marry early because their families believe it makes them less likely to fall pregnant in a transactional sexual relationship. Others marry early if they see it as the only opportunity to make a life after dropping out of school. </p>
<h2>Why is this a problem?</h2>
<p>When girls don’t get into secondary school, they and their communities miss out on the <a href="https://www.globalpartnership.org/blog/why-educating-girls-makes-economic-sense">social, economic and health benefits that accrue from education</a>. </p>
<p>When more girls get to secondary school, this spurs communities to build more secondary institutions. This in turn spurs higher primary school enrolment. It also increases the chances of girls being near the schools they need to attend, which <a href="https://aphrc.org/wp-content/uploads/2023/03/Rapport-IGE-english.pdf">motivates parents</a> to be more committed to supporting their schooling. </p>
<p>When girls get a secondary school education, <a href="https://eric.ed.gov/?id=ED500794">the whole society benefits</a>. Critical thinking skills enable girls to participate in civic duties and drive democratic change in their communities. Educated women are better placed to address some of the health challenges facing their children and their communities, as they are often primary caregivers. </p>
<p>Educated mothers increase the <a href="https://www.worldbank.org/en/topic/girlseducation">immunisation and nutrition intake</a> of their children, reduce the likelihood of child mortality and stunting, have lower fertility rates, and have fewer unwanted pregnancies. </p>
<p>Lastly, going to secondary school reduces the likelihood that girls will contract sexually transmitted diseases, as they are able to access information to change their health behaviour when they are most vulnerable. </p>
<h2>How can parents help turn the tide?</h2>
<p>Parents can help increase the number of girls getting into secondary school if they: </p>
<ul>
<li><p>give equal chances to girls and boys to attend school</p></li>
<li><p>refrain from marrying girls off early</p></li>
<li><p>stop using the excuse that girls are bound to “end up in the kitchen” </p></li>
<li><p>register all their children, including girls, at birth so that they have birth certificates. </p></li>
</ul>
<p>We found that a failure to follow up on the issuance of birth certificates for girls <a href="https://aphrc.org/wp-content/uploads/2023/03/Rapport-IGE-english.pdf">hinders their education</a> beyond primary school, as they are unable to sit for final exams.</p>
<p>The government and education stakeholders need to encourage parents to get more involved in programmes to keep girls in schools. For instance, parents are needed to drive the fight against early marriage and female genital mutilation.</p>
<p>The government should also ensure that the <a href="https://evaw-global-database.unwomen.org/en/countries/africa/senegal/2010/the-framework-for-the-coordination-of-girls-education-interventions">Coordinating Framework of Interventions on Girls’ Education</a> in Senegal works with communities. </p>
<p>Men and boys should be involved in intervention programmes. This has the potential <a href="https://www.unwomen.org/en/what-we-do/youth/engaging-boys-and-young-men-in-gender-equality">to shift power dynamics</a> by challenging gender norms and patriarchal beliefs that men and women aren’t equal. </p>
<p>In the regions where cultural and religious factors hinder girls’ education, parents should be at the forefront of addressing these barriers. They can do this by speaking up against early marriage and keeping girls in schools.</p><img src="https://counter.theconversation.com/content/200294/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Benta A. Abuya is affiliated with The African Population and Health Research Center (APHRC). </span></em></p>Deep-seated cultural practices – such as female genital mutilation and child marriage – prevent girls from making progress in school.Benta A. Abuya, Research Scientist, African Population and Health Research CenterLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1442932020-08-12T14:04:49Z2020-08-12T14:04:49ZSudan’s political change gives hope for young women and girls. Here’s why<figure><img src="https://images.theconversation.com/files/352227/original/file-20200811-19-1ecxt1w.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">An Egyptian doctor gives medical advice to a woman about female genital mutilation during an awareness campaign in Giza, outside the capital Cairo.</span> <span class="attribution"><span class="source">Mohamed El-Sahed/AFP via Getty Images</span></span></figcaption></figure><p><em>Sudan’s transitional government recently announced a nationwide <a href="https://www.theguardian.com/world/2020/jul/12/sudan-bans-fgm-as-it-breaks-with-hardline-islamist-policies">ban</a> on female genital mutilation. A 2014 survey backed by the United Nations estimated 87% of Sudanese women and girls between the ages of 15 and 49 had been subjected to the practice. Most undergo an extreme form known as infibulation. Tamsin Bradley sets out the context in which the ban was announced and the prospects for change under the reformist government.</em></p>
<h2>How widespread is female genital mutilation in Sudan?</h2>
<p>Female genital mutilation, or cutting, is widespread in Sudan. The practice is also <a href="https://www.unfpa.org/female-genital-mutilation">common</a> in Egypt, Somalia and among some groups in the Arabian Peninsula (Oman, United Arab Emirates, Yemen), Iraq and occupied Palestinian territories. It is not common in Bahrain.</p>
<p>The reasons for the practice are the same in all the countries. Most respondents in <a href="https://journals.sagepub.com/doi/abs/10.1177/1464993416674299">social studies</a> indicate reasons such as to maintain cleanliness, increase a girl’s chances of marriage, protect her virginity, discourage “female promiscuity” thus preserving the family honour, improve fertility and prevent stillbirth. Also, femininity is thought to be enhanced through the removal of “masculine” parts such as the clitoris, or in the case of <a href="https://www.who.int/reproductivehealth/topics/fgm/fgm_reinfibulation_central_Sudan/en/">infibulation</a>, to achieve smoothness considered to be beautiful. </p>
<p>Religious reasons are often mentioned and are sometimes misused by groups in favour of the practice to sustain it. Religious leaders in Sudan have yet to put out a common statement, one of the factors that’s hindering efforts to abandon the practice.</p>
<h2>What are its most evident effects on women and girls?</h2>
<p>These are multiple – medically as well as in terms of denying basic human rights. </p>
<p>Female genital mutilation causes long term and serious health problems. This includes making menstruation and childbirth highly risky, painful and ultimately life threatening. If performed outside a medical setting and in unsanitary conditions the practice can cause immediate infection that is painful and long-lasting. Girls are known to have died as a direct result of being cut.</p>
<p>Female genital mutilation operates to maintain girls as objects of control. It denies girls and women autonomy over their own bodies and over life decisions in a broader sense.</p>
<h2>What is the significance of this ban?</h2>
<p>The ban is the result of decades of campaigning. It is evidence of the influence of global, national and local activism that has finally exerted pressure on state governments to enforce the ban. It is also an indication that attitudes are beginning to shift. But there is no room for complacency.</p>
<p>Sudan operates as a federal system. This means that states are allowed to have their own legislation and formulate their own child laws. The first law banning it was passed in the state of South Kordofan in 2008. This was followed by Gadaref state in 2009. Both states ratified a Child Act with an article <a href="http://www.unfpa.org/webdav/site/global/shared/documents/publications/2012/Annual_Report_2011.pdf">banning</a> female genital mutilation.</p>
<p>The challenge was achieving countrywide ratification, which has now happened through the passing of the law by the sovereign council. </p>
<p>But the law alone won’t reduce female genital mutilation. It will have to be supported by highly visible public health and human rights messaging at every level, most critically at the grassroots.</p>
<p>What we have learnt from those early states is that giving effect to a ban requires concerted effort. Additional steps that have been taken include media campaigns at federal, state and community levels. This has included using radio programmes with messages from key informants and leaders, songs and role-plays to encourage abandonment of the practice. </p>
<p>Media campaigns have worked alongside the powerful national “Saleema” campaign. Saleema, which means “whole girl” in Arabic, is a UN-funded social movement designed to emphasise that an empowered, successful girl is uncut. Saleema has facilitated the work of many legislators and activists. It is seen to have contributed significantly to raising the visibility of female genital mutilation and reformulating it as a violation and major health risk rather than a cultural matter.</p>
<h2>A similar law was passed in Egypt but didn’t stop the practice. What are the prospects in Sudan?</h2>
<p>It’s important not to assume that approaches to end female genital mutilation work across contexts. For example, political and economic factors can play a large role. </p>
<p>In the case of Sudan, the country has received donor funding targeted at ending the practice for a number of years. This has helped to build the capacity of activists to push for change. This funding is continuing and will build on the earlier successes. </p>
<p>But a ban can only work if there’s on the ground coordination and commitment at multiple levels. Government must work with donors and implementers. More importantly than anything, change has to be driven by the grassroots. Community activists are key change agents and it is their drive and energy that determines the likely success. Change, even with a new law, will be slow in contexts where activism is not encouraged and civil society is curtailed. </p>
<p>Another reason for hope in Sudan is the country is going through political change. This could open up civil spaces and support the voices of young women and girls who do not want to be cut.</p><img src="https://counter.theconversation.com/content/144293/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Tamsin Bradley does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Political change could open up civil spaces and support the voices of young women and girls who do not want to be cut.Tamsin Bradley, Professor of International Development Studies, University of PortsmouthLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1298272020-03-18T09:42:19Z2020-03-18T09:42:19ZBritish Somalis and FGM: ‘everybody is a suspect – you are guilty until proven innocent’<figure><img src="https://images.theconversation.com/files/310519/original/file-20200116-181634-7how9m.jpg?ixlib=rb-1.1.0&rect=57%2C35%2C4725%2C3147&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/british-muslim-female-friends-walking-urban-588835133">shutterstock/Monkey Business Images</a></span></figcaption></figure><p><a href="https://www.who.int/news-room/fact-sheets/detail/female-genital-mutilation">Female Genital Mutilation</a> (FGM), whereby the female genitals are deliberately injured or changed for non-medical reasons, is considered by the UN to be a “global concern”. </p>
<p>International organisations <a href="https://www.unicef.org/cbsc/files/UNICEF_FGM_report_July_2013_Hi_res.pdf">often report</a> statistical evidence that 98% of women and girls in Somalia/Somaliland have undergone FGM.</p>
<p>Because of this international evidence, girls born to Somali parents living in the UK are considered to be at high risk of experiencing FGM. <a href="https://www.ncbi.nlm.nih.gov/pubmed/15203466">Yet research</a> shows that attitudes towards FGM change dramatically following migration and therefore girls in the UK are <a href="https://www.magonlinelibrary.com/doi/abs/10.12968/johv.2015.3.12.666">unlikely</a> to be put through this procedure. </p>
<p>Concern over the practice of FGM has led the UK government to create policies intended to protect girls at risk. Known as <a href="https://www.gov.uk/government/publications/safeguarding-women-and-girls-at-risk-of-fgm">FGM safeguarding</a>, these policies require professionals – such as teachers, healthcare or youth workers – to report to the police any concerns that a child has had, or could be at risk of, FGM. </p>
<p><a href="https://research-information.bris.ac.uk/files/187177083/Karlsen_et_al_2019_When_Safeguarding_become_Stigmatising_Final_Report.pdf;">Our research</a> presents the views of Somali families living in Bristol with <a href="https://www.bristol.ac.uk/policybristol/policy-briefings/fgm-safeguarding/">experience of FGM safeguarding</a>. Our findings were collected during six focus groups with 30 Somali men, women and young adults during the summer of 2018. </p>
<p>Somalis in our study were committed to ending FGM, but felt detrimentally affected by existing approaches to FGM safeguarding. A sense of the exploitation of a disempowered community pervaded our discussions.</p>
<h2>Constant safeguarding</h2>
<p>Many of the people we spoke with felt that FGM safeguarding led those in positions of authority and trust to put pressure on families to comply with demands that are stigmatising, unjustified and contrary to their rights as British citizens.</p>
<p>Women experienced FGM safeguarding repeatedly in routine health visits – with midwives, GPs and health visitors. They felt that medical staff prioritised getting information for government FGM statistics over their health needs – without considering the trauma this could cause. </p>
<p>The women spoke about how health professionals repeatedly “put salt on the wound” caused by their own experiences of FGM through relentless and insensitive questioning. In response, participants reported avoiding or being scared to access medical care. One of the women we spoke to told us:</p>
<blockquote>
<p>Before they cared about your health and how the child was feeling. Now it’s just FGM.</p>
</blockquote>
<p>FGM safeguarding in schools usually occurred when parents asked to take their children on holiday during term time. Instead of appropriate guidelines being applied, participants believed that Somalis in Bristol were referred to social services by schools as a matter of course – regardless of any identified level of risk to their children. </p>
<p>These experiences stigmatised, traumatised and alienated Somali families, damaging their trust in schools. As one of the people we spoke with explained:</p>
<blockquote>
<p>I thought that safeguarding was when a child is in danger. But for us it was just because we were Somali.</p>
</blockquote>
<p>Referrals to social services frequently led to unannounced home visits by social workers and (sometimes uniformed) police. These visits scared and traumatised children and received particular condemnation from the people in our study. </p>
<p>Safeguarding officers were described as failing to respect people’s rights to privacy and autonomy. The people described how officers would separate and interrogate family members – including children – and physically search property without justification. </p>
<h2>Everyone a suspect</h2>
<p>Participants repeatedly said that FGM safeguarding treated Somalis like criminals. They felt distrusted and that their needs were ignored. There was a sense that the whole Somali community was targeted unfairly. </p>
<p>They also described the safeguarding policy as inherently racist and felt that wider political and media debates on FGM directly contributed to their personal experiences of racist violence. As one of the participants said:</p>
<blockquote>
<p>Everybody is a suspect. You are guilty until you are proven innocent.</p>
</blockquote>
<p>The people in our study said that their experience of FGM safeguarding had undermined their strong sense of being British and made them feel like they were <a href="https://www.bristolpost.co.uk/whats-on/whats-on-news/fgm-doesnt-define-us-somali-3041083">living in a hostile environment</a>. They also described the ways in which the important work being done by Somali activists to reduce FGM was being ignored and this fed into negative stereotypes about Somali culture.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/310520/original/file-20200116-181653-za7a4y.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/310520/original/file-20200116-181653-za7a4y.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=399&fit=crop&dpr=1 600w, https://images.theconversation.com/files/310520/original/file-20200116-181653-za7a4y.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=399&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/310520/original/file-20200116-181653-za7a4y.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=399&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/310520/original/file-20200116-181653-za7a4y.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=501&fit=crop&dpr=1 754w, https://images.theconversation.com/files/310520/original/file-20200116-181653-za7a4y.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=501&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/310520/original/file-20200116-181653-za7a4y.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=501&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Somali families feel ‘stigmatised’ by female genital mutilation safeguarding practices.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/kuala-lumpur-malaysia-sept-2-unidentified-160575962">Shutterstock/udeyismail</a></span>
</figcaption>
</figure>
<p>People in our study felt that these heavy-handed approaches were encouraged by incorrect beliefs that FGM was still popular among the British Somali population. Our participants explained that people living in the UK were much less supportive of FGM than was assumed. <a href="https://www.magonlinelibrary.com/doi/abs/10.12968/johv.2015.3.12.666">This view</a> is supported by <a href="https://www.ncbi.nlm.nih.gov/pubmed/22312195">other research</a> in <a href="https://www.ncbi.nlm.nih.gov/pubmed/15203466">this area</a>. This questions the value of using FGM statistics from Somalia/Somaliland as the basis for understanding FGM risk to Somali people living the UK. One of the people we spoke to said:</p>
<blockquote>
<p>We are trying to find our identity as British Somalis and we don’t want FGM to be part of that.</p>
</blockquote>
<p>This is why a government review of the statistical evidence underpinning FGM safeguarding policies is urgently needed to find better ways to establish FGM risk.</p>
<p>Healthcare workers must also address evidence which highlights that FGM safeguarding in medical settings can lead to poorer care and traumatise FGM victims. </p>
<p>Similarly, schools must ensure that all approaches to FGM safeguarding are in accordance with existing guidance. Home visits must also only be carried out once reasonable risk has been identified – and conducted in a way that doesn’t feel distressing, criminalising or coercive in nature.</p>
<p>Our research shows that FGM safeguarding services in Britain could be doing great harm, even to the people they intend to protect. Only by working together can services be developed that work for everyone.</p><img src="https://counter.theconversation.com/content/129827/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Saffron Karlsen received funding from the ESRC. This research was funded through the Faculty of Social Sciences and Law, University of Bristol</span></em></p><p class="fine-print"><em><span>Christina Pantazis receives funding from Faculty of Social Sciences and Law, University of Bristol </span></em></p><p class="fine-print"><em><span>Magda Mogilnicka received funding from the ESRC.</span></em></p><p class="fine-print"><em><span>Natasha Carver received funding from the ESRC and the Journal for Law and Society. </span></em></p>Why ‘stigmatising’ and ‘traumatising’ approaches to FGM safeguarding are in urgent need of a review.Saffron Karlsen, Senior lecturer in Social Research, University of BristolChristina Pantazis, Professor of Zemiology, University of BristolMagda Mogilnicka, Research Associate in the School of Sociology, Politics and International Studies, University of BristolNatasha Carver, Lecturer in International Criminology, University of BristolLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1311622020-02-05T11:12:07Z2020-02-05T11:12:07ZWhy it’s so difficult to end female genital mutilation<figure><img src="https://images.theconversation.com/files/314205/original/file-20200207-27519-156pllt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">2000 million women have undergone female genital mutilation and millions more are at risk each year.</span> <span class="attribution"><span class="source">Getty Images</span></span></figcaption></figure><p>As <a href="https://www.un.org/en/observances/female-genital-mutilation-day">the world marks</a> the day of zero tolerance for female genital mutilation, it’s important to reflect on the progress made and the challenges that remain. Shifts in prevalence and changes in the social norms underpinning the practice are slowly <a href="https://www.unicef-irc.org/publications/pdf/fgm_insight_eng.pdf">becoming evident</a>. But the target of eliminating it is still a long way off. </p>
<p>Why is that? </p>
<p>In my book titled <a href="https://www.zedbooks.net/shop/book/global-perspectives-on-violence-against-women-and-girls/forthcoming/">Global Perspectives on Violence against Women and Girls</a>, which is soon to be published, I argue that one reason is failure to fully appreciate the impact of local context on the continuation of a practice. What might work in one country could fail elsewhere. </p>
<p>Both men and women commonly <a href="https://journals.sagepub.com/doi/abs/10.1177/1464993416674299?journalCode=pdja">cite culture</a> as the key reason for observing female genital mutilation. They say it’s an important marker of tradition and identity. Even mothers who can remember the pain and trauma of their own cutting, and who have access to support from local networks and legislation, sometimes defend the practice. </p>
<p><a href="https://www.unicef.org/protection/female-genital-mutilation">Global estimates</a> show that 200 million women have undergone female genital mutilation. An additional 3 million girls worldwide are at risk each year.</p>
<p>Female genital mutilation comprises procedures that involve partial or total removal of the external female genitalia for non-medical reasons.</p>
<p>The practice is concentrated in Africa, the Middle East and Asia, and is carried out mainly for cultural and economic reasons. </p>
<h2>Cultural practices and local contexts</h2>
<p>It’s important to be sensitive to context and diversity across countries when analysing why female genital mutilation happens. In Sierra Leone, for example, a nuanced approach to understanding the roots of the practice generates distinctions with other countries such as Sudan and India. </p>
<p>In <a href="https://heinonline.org/HOL/Page?collection=journals&handle=hein.journals/hhrj23&id=112&men_tab=srchresults">Sierra Leone</a>, female genital mutilation is part of initiation into the bondo, described as a secret society for women mainly because the activities of the group are only shared between members. </p>
<p>The bondos’ primary function is to exert power and influence over the spirit world, which in turn commands economic and political power. The secrecy and the relationship with the spirit world enable members to intimidate non-members. This makes it exceptionally difficult to eradicate female genital mutilation in Sierra Leone.</p>
<p>Girls are initiated from a young age, marking their transition into adulthood. It’s understood that girls learn what it is to be a woman from adult female members. <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)30189-2/fulltext?elsca1=etoc">Reportedly</a> the educational aspect of the society has lessened, mainly because the law now says girls and boys have to attend school at least until they complete their primary education. </p>
<p>But despite the decline in the need for girls to be educated through the bondo, female genital mutilation has – if anything – become more important. Initiation to the society, and the education provided through it, used to involve many weeks in the forest. At the end of this time, female genital mutilation was performed to mark the completed transition. Now the initiation takes only a few days and the focus is on female genital mutilation rather than on the learning of new skills and knowledge.</p>
<p>In <a href="https://journals.sagepub.com/doi/abs/10.1177/1464993416674299">Sudan</a>, the motivations relate to bride price, and pressures to present a sexually pure daughter at marriage, thereby ensuring a higher amount. Shame and honour operate to ensure girls adhere to the practice in order to preserve the standing and respect of their families. </p>
<p>Other economic drivers also come into play. Midwives, poorly paid by the state, make up their income by performing female genital mutilation. It also gives them status with the families of the girls they cut. </p>
<p>As I detail in my <a href="https://www.zedbooks.net/shop/book/global-perspectives-on-violence-against-women-and-girls/forthcoming/n/">book</a>, female genital mutilation is still largely invisible in contexts such as India. </p>
<p>A relatively recent movement has emerged, driven by women from the Dawoodi Bohra Muslim community who have openly shared their cut status and called for the practice to end. The population of this community is around 1.2 million. The Bohra consider themselves a subgroup of the Ismaili Shia Muslims, of which there are around 2 million in the world. It is believed that they originated in Yemen, where the practice of female genital mutilation was – and still is – common. </p>
<p>Sahiyo, the organisation founded by women from the Bohra community in 2015, conducted an <a href="https://www.tavinstitute.org/wp-content/uploads/2018/08/TIHRsynthesisDB2018.pdf">online survey</a> in 2017. Of the 400 women who responded, 80% disclosed that they were cut.</p>
<h2>Going forward</h2>
<p>I’ve reviewed just a few contrasting contexts in which female genital mutilation continues to flourish. Local knowledge remains centrally important in understanding why. It’s also important to build community networks supported by a larger and well-resourced enabling environment through which messages to end the practice can be spread. </p>
<p>These messages need to be tailored according to the specific political, economic and cultural factors that intersect and keep the practice going even when there are <a href="https://data.unicef.org/topic/gender/gender-disparities-in-education/">positive signs</a> of development, such as the education of girls.</p><img src="https://counter.theconversation.com/content/131162/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Tamsin Bradley does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>An estimated 2000 million women have undergone female genital mutilation and millions more are at risk. The practice is carried out mainly for cultural and economic reasons.Tamsin Bradley, Professor of International Development Studies, University of PortsmouthLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1162062019-05-02T14:32:41Z2019-05-02T14:32:41ZBreast ironing: a harmful practice that doesn’t get sufficient attention<figure><img src="https://images.theconversation.com/files/272193/original/file-20190502-103045-lqz7eq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Mothers iron their daughters' breasts as a way of preventing early marriage and keeping their daughters in school for longer. </span> <span class="attribution"><span class="source">Shutterstock</span></span></figcaption></figure><p>Recent news reports in the UK of <a href="https://www.theguardian.com/global-development/2019/mar/04/breast-ironing-victims-urge-stronger-action-to-root-out-dangerous-custom">breast ironing</a> portray yet more ways in which culture causes harm to young girls. The reports followed renewed calls for stronger action against the <a href="https://fic.tufts.edu/assets/Understanding-breast-flattening.pdf">practice</a>, which is observed to prevent the development of a girl’s breasts and subsequently reduce the sexual attention she may receive. It involves using an object to massage, pound, or press the breasts flat. </p>
<p>Breast ironing is <a href="https://fic.tufts.edu/assets/Understanding-breast-flattening.pdf">common</a> in West and Central Africa, including Guinea-Bissau, Chad, Togo, Benin, Guinea-Conakry, Côte d’Ivoire, Kenya and Zimbabwe. It’s particularly prevalent in <a href="https://www.athensjournals.gr/health/2016-3-4-5-Vitalis-Pemunta.pdf">Cameroon</a>: there, the number of girls who have been subjected to breast ironing is estimated be as high as one in three (around 1.3 million). </p>
<p>According to the United Nations, <a href="https://www.athensjournals.gr/health/2016-3-4-5-Vitalis-Pemunta.pdf">3.8 million teenagers</a> worldwide have been affected by breast flattening. It’s estimated that about <a href="https://www.theweek.co.uk/71429/what-is-breast-ironing-and-how-common-is-it-in-britain">1 000 girls</a> from West African communities across the UK have been subjected to the practice, but the figure could be much higher. </p>
<p>While reports on the horrors of female genital mutilation, forced marriage and so-called honour killings are common, people are perhaps less aware of the practice where young girls, as puberty sets in, have their breasts ironed flat. </p>
<p>I have established this during 15 years of research into “<a href="https://www.routledge.com/products/isbn/9781472428882">harmful cultural</a> practices” around the world. The practice mirrors ugly misogynistic beliefs and values that underpin other abusive practices. It is ultimately reflective of a power dynamic that demands female submissiveness and complete control over the sexuality of women and girls. </p>
<h2>The socialisation of young girls</h2>
<p>Breast ironing has been an embedded part of the socialisation of young girls from affected communities for quite some time. The medical consequences can be severe. The practice can include the use of grinding stones, spatulas, brooms and belts to tie or bind the breasts flat. Sometimes leaves which are believed to have medicinal or healing qualities are used, as well as plantain peels, hot stones and electric irons. </p>
<p>The practice is usually carried out by mothers, shamans and healers. Some midwives perform the practice. This makes it a source of income, in a way that’s similar to <a href="https://journals.sagepub.com/doi/pdf/10.1177/1464993416674299">female genital mutilation</a>. </p>
<p>The growth of a girl’s breasts during puberty is seen as linked to the emergence of her sexuality; if left unchecked, this will bring “problematic” and “destructive” implications for family and community <a href="https://researchportal.port.ac.uk/portal/en/publications/women-violence-and-tradition-taking-fgm-and-other-practices-to-a-secular-state(cfa5fe44-a87c-4593-980e-69cbe830c159).html">status quo</a> (patriarchy). </p>
<p>However, this gendered reading of the practice is further complicated by <a href="https://fic.tufts.edu/assets/Understanding-breast-flattening.pdf">research</a> that suggests mothers begin ironing the breasts of their daughters as a way of trying to prevent early marriage and keep daughters in school for longer. </p>
<p>In other words, if a girl’s breasts can be held back from developing they will not be <a href="https://www.bbc.co.uk/news/education-47695169">viewed</a> as ready for marriage and childbirth and so will be free to continue with their education for longer. </p>
<p>Understanding the <a href="http://news.trust.org//item/20131205132047-15osx/">drivers</a> behind the practice is obviously critical if routes to change are going to be identified. Clearly breast ironing is not the answer to child marriage. But in contexts where there are few choices, it seems to offer some mothers the only viable way of giving their daughters a little longer to become educated enough to have options.</p>
<h2>A global problem</h2>
<p>Female genital mutilation and breast ironing needs to be situated within a broader ideology that sees female sexuality as shameful and something to be hidden and denied. </p>
<p>Globally, there are efforts to reverse this mindset. UK Aid, for example, funds a social movement called <a href="https://www.thegirlgeneration.org/">The Girls Generation</a> which works throughout Africa to reverse the social norms underpinning female genital mutilation. </p>
<p>The replacement of harmful practices such as female genital mutilation and breast ironing with other new rituals that celebrate the female body will hopefully, in time, help reverse these negative views. </p>
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Read more:
<a href="https://theconversation.com/how-to-target-resources-in-efforts-to-end-female-genital-mutilation-109805">How to target resources in efforts to end female genital mutilation</a>
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<p>Unravelling the prevalence of this practice and the reasons behind it will not be helped by <a href="https://www.theweek.co.uk/71429/what-is-breast-ironing-and-how-common-is-it-in-britain">news reporting</a> – as happened in the UK – that depicts breast ironing as evidence of yet more horrors harboured by “other cultures”. </p>
<p>The focus needs to be on the underlying structural inequalities that continue to devalue the bodies of women and girls. This is a global problem and not something unique to specific parts of the world.</p><img src="https://counter.theconversation.com/content/116206/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Tamsin Bradley does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Close to 4 million teenage girls are subjected to breast ironing worldwide. This harmful cultural practice, which is most prevalent in West and Central Africa, needs to stop.Tamsin Bradley, Professor of International Development Studies, University of PortsmouthLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1098052019-01-30T13:59:08Z2019-01-30T13:59:08ZHow to target resources in efforts to end female genital mutilation<figure><img src="https://images.theconversation.com/files/256086/original/file-20190129-42594-10hiy96.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Shutterstock</span></span></figcaption></figure><p>A new study shows that 130 million women <a href="https://www.popcouncil.org/uploads/pdfs/2016RH_FGMC-Factsheet.pdf">have undergone</a> female genital mutilation (FGM) in 29 of the highest prevalence countries, many of which are in Africa. And 30 million more girls in Africa under the age of 15 will be at risk in the coming decade. </p>
<p>FGM types I-III comprise all procedures that involve partial or total removal of the external female genitalia for non-medical reasons. </p>
<p>The practice is <a href="https://www.who.int/news-room/fact-sheets/detail/female-genital-mutilation">concentrated</a> in Africa, the Middle East and Asia and is carried out mainly for cultural and economic reasons. “Cut” girls are seen to be sexually pure, necessary for marriage, to protect the family’s honour and to get a good bride-price. But FGM carries <a href="https://www.who.int/reproductivehealth/topics/fgm/health_consequences_fgm/en/">signifcant</a> health implications from severe pain and bleeding to numerous infections and even death as a result. </p>
<p>The pressure is on to understand what works to reverse this practice and see it at an end. </p>
<p>In <a href="https://journals.sagepub.com/doi/abs/10.1177/1464993416674299">my research</a> I investigated what anti-FGM programmes were being run in Sudan. FGM isn’t uniformly present in Sudan but, <a href="https://www.cmi.no/publications/file/6229-weak-law-forbidding-female-genital-mutilation-in.pdf">on average</a>, there’s a national prevalence of 66% with 84% in Northern states to 46% in West Darfur.</p>
<p>Anti-FGM interventions target areas with the highest prevalence, and there are many different organisations working towards this end. This has produced a highly complex web of policies and interventions with each organisation focused on implementing its own activities which range from public health campaigns to community advocacy work. </p>
<p>Because these interventions are mostly designed by global and national agencies and governments, they risk ignoring, and even sidestepping, important change agents – like youth and youth organisations – who are <a href="https://face2faceafrica.com/article/check-out-the-young-africans-fighting-to-end-fgm-in-their-countries-photos">already</a> challenging FGM from within. Young people are having conversations with their families and peers and challenge their support of the practice. </p>
<p>Efforts to end FGM should be directed at finding and encouraging these emerging networks that no longer want to be part of a community or family that practice it. </p>
<h2>Medicalisation</h2>
<p><a href="https://www.prb.org/understanding-the-impact-of-medicalisation-on-female-genital-mutilation-cutting/">One approach</a> to ending FGM, that’s getting a lot of attention from international donors, is “medicalisation” – when the practice is performed by a medically trained practitioner, like a doctor, rather than a traditional “cutter”. </p>
<p>Because much of the campaigning in countries, like Sudan and Egypt, has <a href="https://www.28toomany.org/thematic/medicalisation/">emphasised</a> the harmful impact of the practice, it’s led to an increase in medical professionals doing the procedures. <a href="https://www.popcouncil.org/uploads/pdfs/2018RH_MedicalizationFGMC_update.pdf">In Sudan</a>, 67% of all cut women have undergone the practice by a medial practitioner – the highest medicalisation rate in the world. In Egypt, the second highest, rates are at 42%. </p>
<p>Some medical professionals <a href="https://www.sciencedirect.com/science/article/pii/S1110570413000271">argue</a> that medicalisation is positive as it reduces the risk of infection and long-term complications. But it masks a lack of progress in de-normalising the practice and putting an end to it. </p>
<p>Another worry on the impact of current interventions, is a shift between the <a href="http://www.endfgm.eu/female-genital-mutilation/what-is-fgm/">three</a> different types of FGM rather than an end altogether. By emphasising the long-term damage of the most extreme type, health messaging and human rights campaigns <a href="https://www.journals.uchicago.edu/doi/full/10.14318/hau6.2.008">have unintentionally</a> shifted the focus from the most extreme to a less severe version.</p>
<h2>Youth perceptions</h2>
<p>The purpose of my research is to try and understand what the most effective triggers are in changing the minds of families that support FGM. I found that local activists’ viewpoints are being squeezed by a focus on top-down change –when, to effectively address FGM, the process should be bottom up as it’s a cultural issue.</p>
<p>For instance, one of the main barriers to ending FGM is its culturally strong link to marriage, specifically the view that a girl must be cut in order to preserve sexual purity and family dignity. </p>
<p>Shifts in youth perception are already happening that challenge this. Young men <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4599697">increasingly declare</a> that they do not want to marry cut girls. Saying that they prefer uncut girls because they are healthier and stronger. Young women are also challenging FGM, <a href="https://core.ac.uk/download/pdf/81618203.pdf">arguing that</a> it violates their sexual identity and expression.</p>
<p>But these views <a href="https://core.ac.uk/download/pdf/81618203.pdf">are often</a> hidden by an aggressively conservative discourse propounded by politicians and religious leaders that rises in backlash to suggestions that FGM must end. </p>
<h2>Moving forward</h2>
<p>Efforts must support these youth groups and bring them together. </p>
<p>It’s also critical that support is increased for girls who continue to be cut. The stigma associated with FGM is <a href="https://journals.sagepub.com/doi/abs/10.1177/1464993416674299">beginning</a> to work both ways. Cut girls <a href="https://orchidproject.org/wp-content/uploads/2013/02/Sudan-Country-Page.pdf">feel</a> stigmatised by the human rights discourse that describes them as un-whole while uncut girls still feel the pressure to hide their status in case it brings shame on their family.</p>
<p>While my findings highlights how complex the issue of ending FGM is, they also show that activists against FGM are beginning to see more clearly how resources and efforts should be targeted.</p><img src="https://counter.theconversation.com/content/109805/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Tamsin Bradley receives funding from UK Department for International Development. I am part of the evaluation team for UK Aid's Free Sudan from FGC intervention programme</span></em></p>Efforts to end female genital mutilation are mostly designed by global and national agencies and risk ignoring change agents like the youth who are against the practice.Tamsin Bradley, Professor of International Development Studies, University of PortsmouthLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/907582018-04-18T13:35:33Z2018-04-18T13:35:33ZHow practices, and meaning, of genital cutting are changing in Tanzania<figure><img src="https://images.theconversation.com/files/214713/original/file-20180413-560-1clyja3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Circumcision of both boys and girls is practiced by the Maasai in Tanzania.</span> <span class="attribution"><span class="source">Dai Kurokawa/EPA</span></span></figcaption></figure><p>Three decades into a <a href="https://www.huffingtonpost.co.uk/jacqui-hunt/growing-global-movement-t_b_14000082.html">global campaign</a> to end the cultural practice of female genital mutilation and cutting worldwide, the desired change is yet to be achieved. </p>
<p>Various studies suggest that the practice is on the decline in many countries. But <a href="http://gh.bmj.com/content/2/4/e000467">prevalence has increased</a> Chad, Mali and Sierra Leone. The results are also mixed within countries. While the overall prevalence in Ethiopia has gone down, the prevalence <a href="https://dhsprogram.com/publications/publication-FR328-DHS-Final-Reports.cfm">among certain ethnic groups</a> stays more or less unchanged.</p>
<p>The same is true of Tanzania. The national prevalence has decreased from 18% in 1996 to 10% in 2016 while the prevalence in Arusha and Manyara regions <a href="https://dhsprogram.com/pubs/pdf/FR321/FR321.pdf">remains high</a> at 41% and 58% respectively.</p>
<p>This doesn’t mean that campaigns against these practices have not had any effect – just possibly not always the desired effect. Understanding what has changed or stayed the same, and why, could reveal better ways to protect women’s health and social status. </p>
<h2>A study in Tanzania</h2>
<p>The prevalence of the practice among the Maasai of northern Tanzania has remained the same or even increased based on <a href="https://dhsprogram.com/pubs/pdf/FR243/FR243%5B24June2011%5D.pdf">demographic and health survey data</a>. Data from 2010 showed there was no decrease since 2005 and there was even a slight increase of 4.1% in Arusha, in the north of the country. This was despite spirited campaigning and interventions going on in the region. We <a href="https://www.tandfonline.com/doi/full/10.1080/13691058.2017.1313449">set out to qualitatively interrogate</a> what was going on there. </p>
<p>Among the Maasai, circumcision of both boys and girls functions as a rite of passage from childhood to adulthood. It traditionally culminates in a three day public ceremony during which the youngsters are coached on their new roles and responsibilities in the community.</p>
<p>Efforts by civil society and the Tanzanian government to discourage the practice out of health and human rights concerns have not always had the <a href="http://eprints.brighton.ac.uk/11606/1/Winterbottom%20et%20al%202009%20Female%20genital%20cutting.pdf">desired impact</a> to prevent all Maasai girls from being cut. But our study found that these efforts have an important influence on the cultural meaning of the cut. They also modified the place and time when the cut takes place and altered the context of the ceremonial rite of passage. </p>
<p>What is more, these efforts have unintentionally put women’s health at risk by driving the practice underground. </p>
<h2>Dodging the law</h2>
<p>Most Maasai people are aware of the international campaign to end female genital cutting. They are also aware that the practice is <a href="https://www.equalitynow.org/action-alerts/tanzania-enforcement-law-against-female-genital-mutilation">illegal</a> for minors in Tanzania. To avoid prosecution, our research found, many families cut their daughters in secret – often many years before girls reach adolescence. </p>
<p>At this early age, children will not yet have started attending school. Older girls are forced to miss school during the recovery period and the family would thus be found out. Pre-school girls can go under the radar because they can be secretly confined to the home during recovery. </p>
<p>Other families wait until the girl reaches adolescence but cut her a few weeks before the ceremony or choose a smaller cut. Both strategies are meant to ensure that the girl is physically well enough to participate in the public ceremony where local government officials are often sent in to ensure the female genital cutting ban is being enforced.</p>
<p>The fact that many girls are cut before the ceremony to avoid prosecution allows others to avoid the cut altogether without risking social exclusion. Our ethnographic research found that some families take part in the public ceremony when their daughter reaches adolescence on the false claim that she was cut in secret weeks or years before.</p>
<p>Parents who object to the cut can use the protection of the law to refuse. But this can create tensions in the family, a high price for their daughters to pay.</p>
<h2>Changes in the meaning</h2>
<p>Whether daughters are cut when they are babies or just weeks before the ceremony, the cut no longer takes place during the rite of passage. Girls are not considered women until the ceremony, and thus it is the ceremony, rather than the actual genital cutting, that signifies the passage into womanhood. </p>
<p>This is a change from tradition when the cut used to be an integral part of the meaning. If genital cutting no longer equates to the transition from girlhood to womanhood, why then do so many families continue to put their daughters under the knife? </p>
<p>For some, it is still the combination of being cut (at whichever age) and going through the ceremony (at the beginning of adolescence) that admits girls to adulthood. Others believe that being cut prevents illness and reduces promiscuity. </p>
<p>The majority, however, say that it’s a matter of identity: to be a full member of Maasai society, one needs to be circumcised. </p>
<h2>Reverse and perverse effects</h2>
<p>Our research also found a link between resistance to the cut and antipathy to non-Maasai involvement in trying to stop the practice. Many Maasai see efforts to stop the practice as part of a <a href="http://genderandsecurity.org/projects-resources/research/once-intrepid-warriors-modernity-and-production-maasai-masculinities">long history of interference</a> stretching back to colonial times. </p>
<p>Women’s organisations trying to end cutting complained to us that insensitive interventions by outsiders have resulted in suspicion and defensiveness, and made their work more difficult.</p>
<p>One of the aims of efforts to stop female genital cutting is to improve the health and well-being of girls and women. </p>
<p>During my doctorate research among the Samburu in northern Kenya I found that girls were increasingly cut at a younger age as well. But in contrast to Tanzania, here the ceremony is often abandoned. Girls are left with only the painful part of what used to be a ceremony full of teachings on socio-cultural life and roles. More research is needed here to understand this outcome.</p>
<h2>Way forward</h2>
<p>Well meaning efforts by outsiders can have adverse effects. Using repressive measures and top down approaches that are not embedded in local contexts can drive a cultural practice underground and impede change. </p>
<p>The international community needs to trust that the Maasai (and any other group of people) are willing to change. Indeed, they are already changing according to their own aspirations for the future of their communities by coming up with alternative rites of passage themselves, for example. </p>
<p>We witnessed various initiation rites for girls that included all the ceremonial aspects, but in which the genital cut was replaced with a little incision in the thighs or just pouring of milk. Families themselves came up with this without a top down alternative rite of passage initiative.</p>
<p>The role of outsiders is to offer support in ways that advance this cause but on their own terms and without being insulted in the process.</p><img src="https://counter.theconversation.com/content/90758/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Hannelore van Bavel receives funding from SOAS Research Studentship and SOAS Fieldwork Award.
She volunteers as Research Intern for Orchid Project as part of her PhD project.</span></em></p><p class="fine-print"><em><span>Els Leye and Gily Coene do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Efforts to discourage girls from being cut in Tanzania have changed the cultural meaning and practices around the ceremonial rite of passage.Hannelore van Bavel, PhD Candidate , SOAS, University of LondonEls Leye, Postdoctoral Fellow, Vrije Universiteit BrusselGily Coene, Associate Professor, Vrije Universiteit BrusselLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/866702017-11-12T23:05:27Z2017-11-12T23:05:27ZHow women bring about peace and change in Liberia<figure><img src="https://images.theconversation.com/files/194051/original/file-20171109-13337-1f07fr1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Women wearing their WIPNET T-shirts plan a peace jamboree the day before the Liberian election in October 2017.</span> <span class="attribution"><span class="source">(Carter Center)</span></span></figcaption></figure><p>Liberian President Ellen Johnson Sirleaf was the first woman to lead an African country. Her two terms in office ended <a href="https://www.frontpageafricaonline.com/index.php/op-ed/5987-liberia-pres-sirleaf-legacy-and-new-president-s-challenge">with elections last month</a> since, like the United States, presidents in Liberia are barred from serving more than two terms.</p>
<p>Affectionately known as “Ma Ellen,” Sirleaf took office at the end of a 14-year civil war in which an <a href="https://www.theguardian.com/world/2003/aug/04/westafrica.qanda">estimated 200,000 Liberians were killed.</a> </p>
<p>Sickened and fatigued by war, thousands of Liberian women, <a href="https://tavaana.org/en/content/how-women-liberia-fought-peace-and-won">through mass action,</a> brought about an end to the conflict in 2003. </p>
<p>These same women took great risks to elect Sirleaf on her promise to sustain peace and make gender equality central to her administration’s agenda. <a href="https://www.nytimes.com/2017/03/05/world/africa/liberia-president-ellen-johnson-sirleaf-women-voters.html">Some women</a> hid their sons’ voter ID cards to prevent them from voting for Sirleaf’s opponent; others tricked the young men into exchanging their cards for beer; still others managed market stalls while their female owners went to register to vote and watched babies so that mothers could vote on Election Day.</p>
<p>These women, many of whom belong to the Women in Peace Building Network (WIPNET), are identifiable by their white T-shirts with blue WIPNET insignia. They are a powerful, widely respected group for what they have accomplished and continue to fight for.</p>
<p>When Sirleaf came to power in 2005, the world was electrified. On Inauguration Day in January 2006, proud Liberians, world leaders and dignitaries watched as <a href="https://www.democracynow.org/2006/1/17/ellen_johnson_sirleaf_sworn_in_as">she took the oath of office.</a> </p>
<p>Sirleaf singled out the women in the peace movement, thanking them for their courage, and committed to supporting their agenda. The Sirleaf administration kept some of its promises but with notable challenges. Liberia has tough rape laws, <a href="http://www.friendsofunfpa.org/netcommunity/page.aspx?pid=288">but weak enforcement mechanisms,</a> and in 2016, Parliament signed into a law a <a href="https://www.reuters.com/article/us-liberia-fgm/lack-of-fgm-ban-in-domestic-violence-law-fails-liberias-girls-activists-say-idUSKCN10728F?il=0">new domestic violence bill</a> but removed a ban on female genital mutilation.</p>
<p>At the end of Sirleaf’s two terms in office, peace has held, but the results of progress on gender equality are mixed.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/193853/original/file-20171108-14209-1l4l28p.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/193853/original/file-20171108-14209-1l4l28p.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=364&fit=crop&dpr=1 600w, https://images.theconversation.com/files/193853/original/file-20171108-14209-1l4l28p.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=364&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/193853/original/file-20171108-14209-1l4l28p.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=364&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/193853/original/file-20171108-14209-1l4l28p.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=457&fit=crop&dpr=1 754w, https://images.theconversation.com/files/193853/original/file-20171108-14209-1l4l28p.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=457&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/193853/original/file-20171108-14209-1l4l28p.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=457&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Canadian Prime Minister Justin Trudeau shares a laugh with Liberian President Ellen Johnson Sirleaf in Liberia in November 2016.</span>
<span class="attribution"><span class="source">THE CANADIAN PRESS/Adrian Wyld</span></span>
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<h2>Women and peace huts</h2>
<p>Today, some of the powerful grassroots women who brought Sirleaf to power are at the forefront of running <a href="http://www.unwomen.org/en/news/stories/2016/3/peace-huts-help-liberian-women-rise-post-ebola">what are known as peace huts.</a> Spread across the country, the purposes of these huts are to put women in charge of mediating domestic abuse and other disputes before they escalate, to empower women through entrepreneurial opportunities and to educate them about their rights. </p>
<p>By and large, Liberian women and girls are well aware of their rights, and especially those enshrined in the <a href="http://www.peacewomen.org/SCR-1325">UN Security Council Resolution 1325.</a></p>
<p>Adopted in 2000, the resolution recognizes that women bear the brunt and horrors of war, and calls for women’s full participation in conflict prevention, resolution and peace-building. Peace huts in Liberia are instrumental in teaching women — including those not formally educated — about these rights.</p>
<p>Peace huts work for gender equality, peace and human rights. But they do much more. <a href="http://www.bbc.com/news/world-africa-28755033">The Ebola crisis of 2014</a> led to the deaths of an estimated 11,315 people and strained already fragile health-care systems. Women who ran peace huts in some of the communities stepped in to help the sick and dying, and <a href="http://www.unwomen.org/en/news/stories/2016/3/peace-huts-help-liberian-women-rise-post-ebola">some of them died in the process.</a></p>
<h2>Gains and losses</h2>
<p>There is general agreement among most Liberians that the Sirleaf administration stabilized the country and attracted investment. But there are those who also feel that, notwithstanding a staunch patriarchal culture, women have actually lost ground, especially in politics. </p>
<p>Of the 1,026 approved candidates in the election cycle, only 163 were women, and, in a field of 20 candidates, only one woman, Macdella Cooper, ran for president, <a href="https://www.msafropolitan.com/2017/09/how-ellen-johnson-sirleaffailed-the-african-feminist-agenda.html">and she lost badly.</a></p>
<p>Tackling corruption, infrastructure, youth unemployment and reconciliation by promoting national unity and advancing a peace agenda <a href="http://www.aljazeera.com/news/2017/10/liberia-elections-key-issues-171007095516742.html">topped ballot issues</a> in the elections. </p>
<p>Noticeably absent was a targeted focus on addressing violence against women and girls. </p>
<p>Yet the UN Women’s Global Database on Violence Against Women report that <a href="http://evaw-global-database.unwomen.org/en/countries/africa/liberia">39 per cent of Liberian women</a> between 15-49 years old experience physical and/or sexual violence at the hands of intimate partners at least once in their lifetime. </p>
<p>Women who run peace huts spend much of their time supporting victims of gender-based violence. Where they are available, women work with the police to arrest the alleged perpetrators. But justice for victims is often hampered by a weak legal system.</p>
<p>Nonetheless, Liberian women <a href="https://www.nytimes.com/2017/10/09/world/africa/liberia-women-election.html">rightly view themselves</a> as the guardians of a hard-won peace connected to the fight for gender justice. They view peace as foundational to prosperity that can take root only if there is an end to gender-based violence and respect for rights.</p>
<h2>An uncertain but hopeful future</h2>
<p>The elections on Oct. 10 did not yield clear results. The frontrunners, Sen. George Weah and Vice-President Joseph Boaki, were scheduled for a run-off election on Nov. 7. However, the Liberian Supreme Court recently suspended the second round of voting pending an investigation into allegations of <a href="http://www.bbc.com/news/world-africa-41885629">“fraud and irregularities.”</a></p>
<p>It is, therefore, too early to tell if gender equality will top the new administration’s agenda, but there’s room for guarded optimism. </p>
<p>Large groups of activist women in Liberia are prepared to continue to fight for equality and are unafraid to do so. Wearing their WIPNET T-shirts, women have come out in force in recent years to press the government to change or implement laws, usually with the support of an engaged public. </p>
<p>The new administration would do well to work with women in the peace huts and in civil society to achieve success. Without a strong voice for gender equality, it’s unlikely that the new Liberian government will realize its political goals.</p><img src="https://counter.theconversation.com/content/86670/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Erica Lawson receives funding from Social Science and Humanities Research Council; Social Science and Humanities Review Board, as well as a Graham and Gail Wright Distinguished Scholar Award. </span></em></p>Thousands of Liberian women have banded together to bring about peace and to fight for women’s rights. They’ve changed the face of the African nation.Erica Lawson, Associate Professor of Women's Studies and Feminist Research, Western UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/798512017-11-01T13:37:34Z2017-11-01T13:37:34ZWhy the law against female genital mutilation should be scrapped<figure><img src="https://images.theconversation.com/files/192483/original/file-20171030-18693-1f9mstt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/39771826?src=4NDjjhWWr_5REG48lGnR2w-1-1&size=medium_jpg">cristapper/Shutterstock</a></span></figcaption></figure><p>Causing grievous bodily harm, including mutilation, has been outlawed in the UK since time immemorial and has been a statutory offence for over 160 years. Despite this, a law banning female genital mutilation (<a href="http://www.who.int/mediacentre/factsheets/fs241/en/">FGM</a>) was <a href="http://www.legislation.gov.uk/ukpga/1985/38/contents">introduced</a> in the UK in 1985. Since then, only one FGM prosecution has been brought to trial, and both defendants were <a href="https://bererblog.wordpress.com/2015/02/10/acquittals-in-the-fgm-case-in-london-justice-was-done-and-was-seen-to-be-done-but-what-now/">acquitted</a>. There has yet to be a conviction under the FGM Act. </p>
<p>It is curious enough that the statute has hardly ever been used, but there are other reasons why the <a href="http://journals.sagepub.com/doi/abs/10.1177/1350506809350857">exception made for FGM</a> to have its own law now needs to be reconsidered. The problem of FGM was initially considered to be so extreme and so prevalent that it was thought that extra protection under the law was needed in a belt-and-braces approach, but we believe <a href="https://www.researchgate.net/publication/315757652_Ban_without_Prosecution_Conviction_without_Punishment_and_Circumcision_without_Cutting_A_Critical_Appraisal_of_Anti-FGM_Laws_in_Europe">this is no longer necessary</a>.</p>
<p><a href="https://www.rcog.org.uk/en/guidelines-research-services/guidelines/gtg53/">FGM</a> is practised for a variety of cultural reasons and involves the ritual cutting or removal of some or all of the external female genitalia. It has no health benefits, but does have <a href="https://www.rcog.org.uk/en/guidelines-research-services/guidelines/gtg53/">well-documented harms</a>. </p>
<p><a href="http://www.who.int/reproductivehealth/topics/fgm/prevalence/en/">One in 10</a> cases of FGM are the most severe form, known as type 3. This involves the greatest removal of tissue and sewing up of the vaginal entrance. An opening can be made in the scar tissue for childbirth (called “reversal”), but tissue cannot be restored. Doctors can attempt to reconstruct the clitoris, if it has been removed, but the procedure is not always possible, or <a href="http://www.sciencedirect.com/science/article/pii/S0140673612604000">successful</a>. </p>
<h2>Hypocrisy</h2>
<p>In children, FGM has parallels with the ritual circumcision of baby boys. Critics think it is inconsistent, if not hypocritical, that one practice is banned while the other is allowed. </p>
<p>In adults, FGM has parallels with cosmetic surgery. Under the FGM Act, it is illegal for a women in the UK to request having her vagina closed again (re-infibulation), following childbirth. It occurs in the few countries that practice type 3 FGM. In the UK, re-infibulation is always considered criminal, maybe protecting women from coercive cultural pressures, but potentially also denying their free choice. On the other hand, the Act specifically exempts those adults who choose to have female cosmetic genital surgery – operations largely performed in the private sector. </p>
<p>For instance, a plastic surgeon who removed a healthy 33-year-old woman’s clitoris, at her request, <a href="http://www.standard.co.uk/news/health/doctor-cleared-over-fgm-says-women-should-be-free-to-have-intimate-surgery-a3477941.html">wasn’t prosecuted under the FGM Act</a> and neither was the psychiatrist who cleared her for the surgery. Given these contradictory positions, opponents of the FGM Act are increasingly wondering whether this is an example of <a href="https://www.academia.edu/10197867/Between_moral_relativism_and_moral_hypocrisy_reframing_the_debate_on_FGM_">moral relativism</a> and <a href="http://www.shiftingsands.org.uk/fgm-legislation-is-too-weak-and-too-strong/">bad law</a>.</p>
<p>Generally, <a href="https://www.gov.uk/government/publications/female-genital-mutilation-resource-pack/female-genital-mutilation-resource-pack">criminal law</a> is intended to prevent or punish an outlawed behaviour. The existence of a law acts symbolically to prevent the outlawed acts. Prosecution is the means to punish them when they occur. The desired end, of having less (or no) FGM, especially of children, is achieved by the absence of FGM, not by the presence of prosecutions. </p>
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<img alt="" src="https://images.theconversation.com/files/192488/original/file-20171030-18735-103fyze.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/192488/original/file-20171030-18735-103fyze.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=329&fit=crop&dpr=1 600w, https://images.theconversation.com/files/192488/original/file-20171030-18735-103fyze.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=329&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/192488/original/file-20171030-18735-103fyze.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=329&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/192488/original/file-20171030-18735-103fyze.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=414&fit=crop&dpr=1 754w, https://images.theconversation.com/files/192488/original/file-20171030-18735-103fyze.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=414&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/192488/original/file-20171030-18735-103fyze.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=414&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/653746102?src=d5Akuf4vrNDsA4sfhYOTZQ-1-4&size=huge_jpg">Fang-Chun Liu/Shutterstock</a></span>
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<h2>No longer needed</h2>
<p>The demand for prosecutions is a “tough” approach taken by the authorities, but it is not a primary desired end in itself. It may appear counter-intuitive that we think that the lack of successful prosecutions may be supportive evidence that the law is functioning successfully (if not completely) by encouraging <a href="https://www.rcm.org.uk/sites/default/files/FGM%20Survey%20FINAL_0.pdf">positive changes in attitude</a>. We do not advocate scrapping the specific FGM law because it is too difficult to enforce, but because it is no longer needed. </p>
<p>Up to now, the law may have worked by drawing attention to the issue and by setting an expectation of acceptable behaviour for new migrants. But there are difficulties and <a href="http://www.bbc.co.uk/programmes/b094mnx3">unintended effects</a>, including concerns that the current law is <a href="http://journals.sagepub.com/doi/abs/10.1177/1477750916682671">discriminatory about race</a>. </p>
<p>It has proven difficult to prosecute FGM due to its familial and hidden nature, the shortage of experienced and <a href="https://www.researchgate.net/publication/307877960_B_and_G_Children_No_2_2015_EWFC_3_Family_Court_England_and_Wales_Sir_James_Munby_President_of_the_Family_Division_High_Court_of_England_Wales_14_January_2015">competent experts</a>, low numbers of reports, and a first <a href="https://www.theguardian.com/society/2015/feb/04/first-female-genital-mutilation-prosecution-dhanuson-dharmasena-fgm">failed prosecution</a> of a doctor. In any event, established law already includes FGM in its remit (<a href="http://www.legislation.gov.uk/ukpga/Vict/24-25/100/contents">Offences Against the Person Act 1861</a>) and also safeguards children (<a href="http://www.legislation.gov.uk/ukpga/2004/31/contents">Children Act</a>). </p>
<p>So, rather than concentrating on government pressure to achieve a successful prosecution with unnecessary law, we could instead divert scarce resources to continuing prevention – such as education, provision of specialist health clinics and community support services. Also, there is evidence that the communities who practice FGM are giving it up with <a href="https://www.unicef.org/media/files/FGMC_2016_brochure_final_UNICEF_SPREAD.pdf">falling prevalence worldwide</a>, though sadly numbers may still rise due to population growth.</p>
<p>Lastly, the involvement of doctors legitimises surgery. Globally, “medical reasons” are used to justify and perform male infant circumcision. Likewise, medicalisation is used to justify FGM in some countries (Egypt and Malaysia) where <a href="https://www.madamasr.com/en/2016/02/06/feature/society/when-its-the-doctors-carrying-out-female-circumcision/">doctors perform “female circumcision”</a> more safely under anaesthetic, but still without any therapeutic benefit. The law should bring consistency into medical practice: either by banning <a href="https://aeon.co/essays/are-male-and-female-circumcision-morally-equivalent">male infant circumcision</a> or by <a href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)31807-X/fulltext">recognising the harms of this traditional practice</a>. </p>
<p>Doctors in the UK are faced with two <a href="https://aeon.co/essays/are-male-and-female-circumcision-morally-equivalent">discriminatory conundrums</a>: a consenting adult female with normal genitalia can have major genital modification, yet a new mother who had FGM as a child cannot be re-infibulated; girls cannot undergo genital modification as unconsenting <a href="http://www.bbc.co.uk/news/health-40410459">children</a>, but boys can. </p>
<p>Increasingly, bodies representing the professional interests of medical doctors, such as in <a href="http://www.dutchnews.nl/features/2017/06/male-circumcision-is-violation-of-bodily-integrity/">the Netherlands</a>, are cited as saying the health risks of infant male circumcision outweigh the benefits.</p>
<h2>Eroding trust</h2>
<p>Finally, in the efforts to prosecute FGM, <a href="http://blog.practicalethics.ox.ac.uk/2015/10/mandatory-submission-of-patient-information-about-fgm-a-pointless-damaging-discriminatory-mess/">mandatory reporting</a> and recording of all old and new FGM by doctors has been introduced – which raises <a href="http://www.bmj.com/content/351/bmj.h5146">concerns about confidentiality</a> and erosion of trust in the medical profession. Doctors do not have to ring the police about other criminal events reported by victims that occurred long ago and elsewhere. This extra reporting may cause a loss in trust, not only of individual patients, but of whole communities. </p>
<p>The UK could introduce consistency with a Child Genital Modification Act which would make any non-medical genital modifications of male and female infants illegal because the medical benefits are negligible, at best, and the risks great. Alternatively, given that we already have criminal law that would cover FGM and inappropriate surgical cuttings by doctors in the <a href="http://www.legislation.gov.uk/ukpga/Vict/24-25/100/contents">Offences Against the Person Act 1861</a>, why do we need the FGM Act at all? It is not <a href="http://www.shiftingsands.org.uk/fgm-legislation-is-too-weak-and-too-strong/">fit for purpose</a> and should go.</p><img src="https://counter.theconversation.com/content/79851/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Lynne Townley is affiliated with Save Your Rights, a charity campaigning against forced marriage and a committee member of Association of Women Barristers (a voluntary organization campaigning for access to the Bar for women and other under-represented groups). She has lectured and published articles on FGM and was the Legal Advisor on NHS Health Education England E-learning for Health FGM Learning Programme.</span></em></p><p class="fine-print"><em><span>Susan Bewley was involved in setting up the UKs second FGM clinic as Director of Obstetrics at Guy’s & St Thomas’ Hospitals in 1996. She has a research interest in violence against women, and has published and lectured on FGM. She was a expert for the defence in R vs Dharmasena.
</span></em></p>The UK’s FGM Act is discriminatory and inconsistent.Lynne Townley, Lecturer in Law, City, University of LondonSusan Bewley, Professor of Women's Health, King's College LondonLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/859602017-10-25T00:07:17Z2017-10-25T00:07:17ZIt’s not just O'Reilly and Weinstein: Sexual violence is a ‘global pandemic’<p>The recent exposure of <a href="https://www.nytimes.com/2017/10/05/us/harvey-weinstein-harassment-allegations.html">widespread sexual predation in the American media industry</a>, from Harvey Weinstein to <a href="https://www.nytimes.com/2017/10/21/business/media/bill-oreilly-sexual-harassment.html?_r=0">Bill O'Reilly</a>, has elicited shock and sparked debate on violence against women in the United States. </p>
<p>Sexual harassment isn’t the exclusive domain of show biz big shots. It remains alarmingly prevalent nationwide, even as <a href="http://www.pewresearch.org/fact-tank/2017/02/21/5-facts-about-crime-in-the-u-s/">other crimes are generally decreasing</a> nationwide. </p>
<p>In the U.S., a 2006 study found that 27 percent of <a href="http://journals.sagepub.com/doi/abs/10.1177/1077801205277358">college women</a> reported some form of forced sexual contact – ranging from kissing to anal intercourse – after enrolling in school. This sexual violence is heavily <a href="https://www.rainn.org/statistics/campus-sexual-violence">underreported</a>, with just 20 percent of female student victims reporting the crime to law enforcement.</p>
<p>Nor is sexual harassment limited to the United States. The U.N. has called gender-based violence <a href="http://www.un.org/apps/news/story.asp?NewsID=49443#.We-gOa2ZOU0">a “global pandemic</a>.” As experts in emergency medicine and legal research at the <a href="https://hhi.harvard.edu">Harvard Humanitarian Initiative</a>, we believe it’s important to acknowledge that this issue transcends national borders and class boundaries to touch the lives of roughly 33 percent of all women worldwide.</p>
<h2>A world of trouble</h2>
<p>According to <a href="http://apps.who.int/iris/bitstream/10665/43310/1/9241593512_eng.pdf">World Health Organization</a> estimates, one in three women worldwide will experience either physical or sexual violence in her lifetime, many of them before the age of 15. </p>
<p>In fact, for many rural women, their first sexual encounter will be a forced one. Some 17 percent of women in rural Tanzania, 21 percent in Ghana, 24 percent in Peru, 30 percent in Bangladesh and 40 percent in South Africa <a href="http://apps.who.int/iris/bitstream/10665/43310/1/9241593512_eng.pdf">report</a> that their first sexual experience was nonconsensual.</p>
<p>Intimate partner violence is also pervasive globally. In one <a href="http://apps.who.int/iris/bitstream/10665/42495/1/9241545615_eng.pdf">World Health Organization study</a>, 22 to 25 percent of women surveyed in cities in England, Mexico, Nicaragua, Peru and Zimbabwe reported that a boyfriend or husband had committed some form of sexual violence against them. Globally, up to 55 percent of women murdered are killed by <a href="https://www.cdc.gov/mmwr/volumes/66/wr/mm6628a1.htm?s_cid=mm6628a1_w">their partners</a>.</p>
<p>Violence against women takes many <a href="http://www.who.int/hac/techguidance/pht/SGBV/en/">forms</a>, ranging from psychological abuse to the kind of sexual predation, sexual assault and rape allegedly committed by Harvey Weinstein. Honor killings, physical attacks, female infanticide, <a href="https://theconversation.com/in-sudan-movies-made-by-researchers-change-the-way-people-see-female-genital-cutting-70824">genital cutting</a>, trafficking, forced marriages and sexual harassment at work and school are also considered gender-based violence.</p>
<p>Rates range from country to country – from 15 percent in Japan to 71 percent in Ethiopia – but violence is, in effect, a ubiquitous female experience.</p>
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<p>Sexual violence is committed at particularly high rates in <a href="https://theconversation.com/why-home-even-when-theres-war-is-the-most-dangerous-place-for-women-81867">crisis settings</a> like war zones, refugee camps and disaster zones.</p>
<p>In these places, even humanitarian workers are not immune. <a href="https://theconversation.com/aid-workers-face-an-underreported-sexual-violence-crisis-74667">Dyan Mazurana</a> and her colleagues at Tufts University <a href="http://fic.tufts.edu/publication-item/stop-the-sexual-assault-against-humanitarian-and-development-aid-workers/">found</a> that many female development-aid staffers in places such as South Sudan, Afghanistan and Haiti had experienced disturbing rates of sexual assault, often perpetrated by their own colleagues. </p>
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<h2>Explaining sexual violence</h2>
<p>So what’s driving this pervasive phenomenon? Research reveals that there are <a href="http://apps.who.int/iris/bitstream/10665/43310/1/9241593512_eng.pdf">multiple</a> <a href="http://www.who.int/mediacentre/factsheets/fs239/en/">causes</a> of sexual violence, among them gender inequality and power differentials between men and women. </p>
<p>For example, <a href="http://www.nsvrc.org/sites/default/files/Publications_NSVRC_Booklets_Global-perspectives-on-sexual-violence.pdf">sexual violence occurs more frequently</a> in cultures where violence is widely accepted and where beliefs about family honor, sexual purity and male sexual entitlement are strongly held.</p>
<p>Even in many countries that rank well on gender equality, including in <a href="http://hdr.undp.org/en/composite/GII">the United States</a>, weak legal <a href="http://apps.who.int/iris/bitstream/10665/77434/1/WHO_RHR_12.37_eng.pdf">sanctions against perpetrators of sexual violence</a> can encourage and effectively condone such behavior.</p>
<p>So can cultural acceptance. Weinstein’s sexual predatory behavior was <a href="https://www.washingtonpost.com/lifestyle/style/violence-threats-begging-harvey-weinsteins-30-year-pattern-of-abuse-in-hollywood/2017/10/14/2638b1fc-aeab-11e7-be94-fabb0f1e9ffb_story.html?tid=ss_tw&utm_term=.b69841a6f4f7">longstanding</a> and well-known within the film industry, yet he was allowed to continue his abuse with impunity – until women began speaking up. </p>
<p>Likewise, Fox News <a href="https://www.nytimes.com/2017/10/21/business/media/bill-oreilly-sexual-harassment.html?_r=0">renewed Bill O'Reilly’s contract</a> even after he and the company had made at least six multi-million-dollar settlements with women who <a href="https://www.nytimes.com/2017/04/19/business/media/bill-oreilly-fox-news-allegations.html">filed sexual harassment claims against him</a>. Awareness of a problem is one thing; taking action is quite another. </p>
<p>Men with lower educational levels, or who have been exposed to maltreatment or family violence as children, are <a href="http://www.who.int/mediacentre/factsheets/fs239/en/">more likely</a> to commit sexual violence themselves.</p>
<p>That’s because <a href="http://www.hicn.org/wordpress/wp-content/uploads/2012/06/HiCN-WP-233.pdf">violence begets violence</a>, a relationship that’s abundantly clear in the kinds of conflict zones where we work. Mass rape has long been used as a weapon of war, and has been <a href="https://www.unicef.org/sowc96pk/sexviol.htm">well-documented</a> during conflicts in the Democratic Republic of the Congo, Colombia and South Sudan.</p>
<p>Among the most salient cases are the Rwandan and Bosnian genocides. <a href="https://www.un.org/ruleoflaw/files/womenpeaceandsecurity.pdf">According to the U.N.’s High Commissioner for Refugees</a>, up to 500,000 Rwandan women were systematically raped in 1994 as part of an ethnic cleansing strategy, while tens of thousands of Bosnian women and girls were systematically raped between 1992 and 1995.</p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"921550375739691008"}"></div></p>
<h2>Psychological trauma</h2>
<p>Wherever and however it happens, violence against women and girls poses a major public health problem for women and their communities.</p>
<p>Some 42 percent of women who experience intimate partner violence <a href="http://www.who.int/mediacentre/factsheets/fs239/en/">reported</a> an injury
– including bruises, abrasions, cuts, punctures, broken bones and injuries to the ears and eyes – as a consequence of that abuse. Women who suffer violence are also 1.5 times <a href="http://apps.who.int/iris/bitstream/10665/43310/1/9241593512_eng.pdf">more likely</a> to have sexually transmitted diseases like HIV, syphilis, chlamydia and gonorrhea, twice as likely to experience depression and drinking problems and twice as likely to have an abortion. </p>
<p>Violence against women is also closely <a href="http://apps.who.int/iris/bitstream/10665/42966/1/9241546476_eng.pdf">associated</a> with suicide and self-harm.</p>
<p>If there’s any silver lining to the Weinstein and O'Reilly scandals, it’s that in coming out against these high-profile men, dozens of women have helped to highlight not just the prevalence of sexual violence in the United States but also the societal norms that silence women and allow abusers to go unchecked.</p>
<p>Humanitarian organizations from the <a href="http://apps.who.int/iris/bitstream/10665/44402/1/9789241500128_eng.pdf">World Health Organization</a> to the <a href="http://www.heforshe.org/en/take-action/violence">U.N.</a> to the <a href="https://www.usaid.gov/sites/default/files/documents/1865/Men_VAW_report_Feb2015_Final.pdf">U.S. Agency for International Development</a> have recognized that gender-based violence is not just a women’s issue. Addressing it requires working with men and boys, too, to counter the cultures of toxic masculinity that encourage or tolerate sexual violence. </p>
<p>After all, women’s rights are human rights, so sexual violence is everyone’s problem to solve.</p>
<p>The fact is, societies with high rates of sexual violence are also more likely to be violent and unstable. <a href="http://foreignpolicy.com/2012/04/24/what-sex-means-for-world-peace/">Research</a> shows that the best predictor of a state’s peacefulness is how well its women are treated.</p><img src="https://counter.theconversation.com/content/85960/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Hollywood’s sexual predation scandals are just the tip of the iceberg. One in three women worldwide has been physically or sexually assaulted, and many girls’ first sexual experience is forced.Valerie Dobiesz, Emergency Physician at Brigham and Women's Hospital, Director of External Programs STRATUS Center for Medical Simulation, Core Faculty Harvard Humanitarian Initiative, Harvard UniversityJulia Brooks, Researcher in international law and humanitarian response, Harvard Humanitarian Initiative (HHI), Harvard UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/838922017-09-13T17:00:32Z2017-09-13T17:00:32ZWhy Liberian President Ellen Johnson Sirleaf is no feminist icon<figure><img src="https://images.theconversation.com/files/185638/original/file-20170912-19504-o2j90o.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Ellen Johnson Sirleaf's record on women's rights has been mixed.</span> <span class="attribution"><span class="source">REUTERS/Tiksa Negeri</span></span></figcaption></figure><p>When Liberians go to <a href="http://www.necliberia.org/">the polls</a> in October 2017, there will be a disproportionate number of men on the ballot papers. Only 163 of 1026 approved candidates – just 16% – in these presidential and legislative elections <a href="http://necliberia.org/pg_img/Final%20Candidates%20listing.pdf">are women</a>. This represents only a marginal increase since 2005 and 2011, when women accounted for 14% and 11% of candidates, respectively. </p>
<p>Ellen Johnson Sirleaf – who, 12 years ago, became the <a href="https://www.theatlantic.com/international/archive/2017/03/vote-for-woman-how-africa-got-its-first-female-president/518874/">first woman</a> to be elected head of state in any African country – has often <a href="https://www.nytimes.com/2017/03/05/world/africa/liberia-president-ellen-johnson-sirleaf-women-voters.html?mcubz=0">been hailed</a> as a feminist icon. But the poor representation of women in elections is as much her fault as it is a reflection of Liberia’s acutely <a href="https://www.academia.edu/12656646/Patriarchy_Power_Distance_and_Female_Presidency_in_Liberia">patriarchal political system</a>.</p>
<p>Her presidency has actually served the interests of a small, elite group of women and men in politics. It has upheld the country’s long-standing patriarchal norms. She has publicly distanced herself from the very movement that first got her elected, decrying feminism as “<a href="https://www.theguardian.com/global-development/2017/jul/23/can-president-ellen-johnson-sirleaf-save-liberia">extremism</a>”.</p>
<p>Sirleaf’s brand of <a href="https://www.jstor.org/stable/43657968">femocracy</a> – a term coined by Nigerian feminist scholar Amina Mama – has severely stifled women’s political participation.</p>
<p>Mama, whose research focused on African first ladies as femocrats, makes an important distinction between feminism and femocracy. She argues that while feminism attempts to shatter the political glass ceiling, femocracy deliberately keeps it intact. This remains true even though, some decades on from her original writing, the continent can now boast of women presidents like Sirleaf and former Malawian head of state <a href="http://www.aljazeera.com/news/africa/2012/04/201247163726657558.html">Joyce Banda</a>.</p>
<h2>Women in Liberian politics</h2>
<p>Sirleaf has been conspicuously silent about bolstering women’s roles in politics, apart from a recent public statement in which she <a href="http://www.emansion.gov.lr/2press.php?news_id=4128&related=7&pg=sp">vowed</a> to campaign actively for female candidates in these elections. </p>
<p>There have been some legislative efforts to involve more women in Liberia’s political leadership, with minimal to no input from Sirleaf. </p>
<p>A 2014 elections law <a href="http://necliberia.org/doc_download/New%20Elections%20law%20Amendments.pdf">amendment</a> encouraged political parties to increase their representation of women in leadership roles. Yet Sirleaf’s own Unity Party– with only 10 women out of 58 candidates on its roster – ranks below smaller, less prominent parties in fronting female candidates this year. The United People’s Party, <a href="http://necliberia.org/pg_img/Final%20Candidates%20listing.pdf">for instance</a>, has 17 women candidates out of a total 64.</p>
<p>Elsewhere on the continent Rwanda, Senegal and South Africa have implemented gender equity bills specifically to propel women to <a href="http://www.ipu.org/wmn-e/classif.htm">high public office</a>. In 2010 the Liberian women’s legislative caucus sponsored an <a href="http://www.loc.gov/law/foreign-news/article/liberia-proposal-to-increase-womens-participation-in-politics/">act</a> which mandated that women should occupy at least 30% of political party leadership. The act would also have set up a trust fund to finance women’s electoral campaigns.</p>
<p>Sirleaf did not actively support the proposed law and it was never ratified. </p>
<p>She has also failed women when it comes to her own high-level political appointments. Only four of her current 21 cabinet officials are women – and none of them occupy strategic ministries like defence, finance, education or public works.</p>
<p>Nepotism has been a problem on her watch, too: Sirleaf has appointed <a href="https://www.theguardian.com/global-development/2012/nov/01/liberia-johnson-sirleaf-nepotism-corruption">three of her sons</a> to top government positions. </p>
<h2>A few successes, but…</h2>
<p>This is not to say that Sirleaf’s two terms in office have left women completely high and dry. </p>
<p>Her administration has built or renovated hundreds of markets across the country for thousands of female informal traders called “<a href="http://womensenews.org/2009/03/presidents-fund-repays-liberias-market-women/">market women</a>”. </p>
<p>She has also instituted policies to protect women and girls from male aggression. Under her rule, Liberia has implemented the most comprehensive <a href="http://www.aljazeera.com/topics/regions/africa.html">anti-rape law in Africa</a>. A fast-track special court has been established to deal specifically with gender based violence.</p>
<p>Unfortunately, a decade after it was opened, the court remains only in the capital city, Monrovia. This makes it inaccessible to most Liberian women.</p>
<p>And the person who heads the court, Serena Garlawolu, has gone on record endorsing <a href="http://www.aljazeera.com/indepth/interactive/2016/06/female-genital-mutilation-fgm-160601125718596.html">female genital mutilation</a>. Garlawolu says the practice “is not a violation of anyone’s rights culturally”. Liberian women’s rights activists <a href="http://frontpageafricaonline.com/index.php/news/3315-women-group-wants-female-genital-mutilation-act-put-into-law">petitioned</a> to criminalise the harmful procedure. But the proposed ban was omitted from a recently passed Domestic Violence Act.</p>
<h2>Gender equity</h2>
<p>Sirleaf’s record over the past 12 years demonstrates that gender equity is not magically achieved when a woman occupies a country’s highest political office. This is borne out by countless other examples, including Margaret Thatcher and Theresa May in England, Indira Gandhi in India, Dilma Rousseff in Brazil and Julia Gillard in Australia. </p>
<p>The international media and Sirleaf’s supporters continue to hoist her up as the matron of women’s rights in Africa. However, she does not deserve this title. The evidence of this will be glaringly obvious in the October election results. </p>
<p><em>This article was co-authored with Korto Reeves Williams, a Liberian feminist and a strategic civil society leader in Liberia and the sub-region. It is based on <a href="http://www.aljazeera.com/indepth/opinion/2017/08/liberia-sirleaf-standing-women-170827092802275.html">a piece</a> that was originally published by Al Jazeera English.</em></p><img src="https://counter.theconversation.com/content/83892/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Robtel Neajai Pailey does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>The international media and her supporters continue to hoist Liberian President Ellen Johnson Sirleaf up as the matron of African women’s rights. But she does not deserve this title.Robtel Neajai Pailey, Research associate, University of OxfordLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/769522017-07-04T20:09:18Z2017-07-04T20:09:18ZSurgery to make intersex children ‘normal’ should be banned<figure><img src="https://images.theconversation.com/files/175546/original/file-20170626-32724-121ds44.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C1497%2C992&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Intersex people are born with sexual anatomy that doesn't fit binary notions of male or female bodies. </span> <span class="attribution"><span class="source">Boston Public Library/flickr</span></span></figcaption></figure><p>Questions in the proposed new citizenship test that address family violence, <a href="http://www.smh.com.au/federal-politics/political-news/malcolm-turnbull-targets-labor-over-australian-values-citizenship-quiz-20170419-gvo9jn.html">child marriage and female genital mutilation</a> imply opposition to these is an Australian value.</p>
<p>Indeed most Australians would agree female genital mutilation is an appalling breach of a girl’s right to bodily integrity, and that safeguarding children from violence is a vital goal in modern society. But protection from genital cutting should not only be granted to girls, but to all children. </p>
<p>While condemning female genital mutilation, Australian society appears to broadly accept routine circumcision of young boys, and genital modification surgeries on intersex children where the child’s genitals are reconstructed to resemble those typical of either a male or female. These procedures are legal and supported by Medicare.</p>
<p>In most cases, circumcisions and intersex surgeries occur without medical necessity or urgency: the children are healthy and no adverse medical consequences will arise if the surgery is not carried out immediately. Importantly, children undergoing such surgeries are often too young to understand what is happening to them and are legally too young to provide their consent. </p>
<p>Human rights concerns about underage male circumcision <a href="https://theconversation.com/infant-male-circumcision-stop-violating-boys-human-rights-8517">have been discussed in the past</a>, yet infringements suffered by intersex children are an emerging area of controversy. Medically unnecessary, non-consensual intersex genital modification should be made <a href="http://www.legislation.nsw.gov.au/#/view/act/1900/40/part3/div6/sec45">illegal in Australia in the same way</a> as female genital mutilation.</p>
<h2>Children with intersex variations</h2>
<p>Intersex children are <a href="https://unfe.org/system/unfe-65-Intersex_Factsheet_ENGLISH.pdf">born with sex characteristics</a>, including genitals, gonads (testes and ovaries) and chromosome patterns, that do not fit typical binary notions of male or female bodies. </p>
<p>Nearly 2% of Australia’s population have <a href="https://oii.org.au/16601/intersex-numbers/">intersex variations</a>, which may not always be apparent at birth and may reveal themselves at puberty or later in life. While some intersex people may have atypical external genitalia, others may not. </p>
<p>Intersex variations describe physical or bodily traits – they do not describe gender or sexuality. Like non-intersex folks, intersex people may identify with any number of gender or sexual identities.</p>
<hr>
<p><strong><em>Read more: <a href="https://theconversation.com/boy-girl-or-dilemmas-when-sex-development-goes-awry-49359?sr=7">Boy, girl or …? Dilemmas when sex development goes awry</a></em></strong></p>
<hr>
<h2>Genital “normalising” surgery</h2>
<p>Many intersex children undergo what proponents call genital “normalising” procedures, which implies these children’s bodies are abnormal. The procedures, intended to make the children conform to social norms of male or female bodies, often include irreversible surgical modification of sexual organs. These may result in sterilisation by removal of their gonads (testes or ovaries), and life-long hormone treatments. </p>
<p>Those who advocate for these procedures to be carried out when children are still young often argue the chances of medical success are higher and the children will be able to grow up with a consistent gender identity. However, this ignores the human rights of these children to independently develop a gender identity and decide for themselves whether they want their bodies to be altered irreversibly. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/175550/original/file-20170626-32724-1tot11t.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/175550/original/file-20170626-32724-1tot11t.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/175550/original/file-20170626-32724-1tot11t.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/175550/original/file-20170626-32724-1tot11t.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/175550/original/file-20170626-32724-1tot11t.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/175550/original/file-20170626-32724-1tot11t.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/175550/original/file-20170626-32724-1tot11t.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Safeguarding children from violence is a vital goal in modern society.</span>
<span class="attribution"><span class="source">Man-wise/flickr</span></span>
</figcaption>
</figure>
<p>There are many examples of intersex people who, as children, were subjected to “normalising” procedures without their consent. In the 1970s, intersex advocate <a href="http://www.abc.net.au/local/stories/2014/12/01/4135509.htm">Georgie Yovanovic</a> went through forced medical examinations, hormone treatments, surgery to descend her testicles, and ultimately a unilateral mastectomy without her consent or any explanation from doctors when she was a child and teenager.</p>
<p>Alice Springs-based musician <a href="http://www.abc.net.au/local/stories/2014/12/01/4140196.htm">Shon Klose</a> was born without internal female organs. As a teenager in the 1980s, she was pressured into having medical treatment to create a vagina to have a more typical female body capable of heterosexual penetration. She did not receive any medical counselling, support or information.</p>
<p>Genital “normalising” procedures on young children still occur in Australia today. The recent <a href="http://www.theaustralian.com.au/national-affairs/health/carlas-case-ignites-firestorm-among-intersex-community-on-need-for-surgery/news-story/7b1d478b8c606eaa611471f70c458df0">Family Court of Australia</a> case of five-year-old Carla is an example. Carla was born genetically male but with the external appearance of a female child and had undergone early childhood surgery to enhance the appearance of her genitalia. </p>
<p>In 1992, the High Court of Australia had established a precedent in <a href="http://www.austlii.edu.au/au/cases/cth/high_ct/175clr218.html">Marion’s Case</a>, that parents cannot consent on behalf of their children to have certain types of medical procedures, which therefore require court authorisation. Consequently, in 2015 Carla’s parents, who were raising her as a girl, sought permission to have her gonads surgically removed, which the Family Court granted. </p>
<h2>Human rights violation</h2>
<p>Greater visibility of intersex people is driving increasing resistance to these procedures. There is now growing global criticism of genital modification procedures on intersex children as a violation of human rights. </p>
<p>In 2013, Europe’s leading human rights organisation, the Council of Europe, <a href="http://semantic-pace.net/tools/pdf.aspx?doc=aHR0cDovL2Fzc2VtYmx5LmNvZS5pbnQvbncveG1sL1hSZWYvWDJILURXLWV4dHIuYXNwP2ZpbGVpZD0yMDE3NCZsYW5nPUVO&xsl=aHR0cDovL3NlbWFudGljcGFjZS5uZXQvWHNsdC9QZGYvWFJlZi1XRC1BVC1YTUwyUERGLnhzbA==&xsltparams=ZmlsZWlkPTIwMTc0">identified intersex genital modification</a> as a non-medically justified violation of children’s right to physical integrity. The Council encouraged states to “guarantee bodily integrity, autonomy and self-determination” to intersex people. </p>
<p>In 2015, <a href="https://rm.coe.int/168045b1e6">Malta became the first country</a> to explicitly outlaw the practice. No other country has done so at the time of writing. In the same year, the United Nations Office of the High Commissioner for Human Rights (OHCHR) <a href="http://www.ohchr.org/EN/NewsEvents/Pages/Astepforwardforintersexvisibility.aspx">held a conference</a> to address what it called the human rights violations faced by intersex people. As the first of its kind, the meeting broadened global awareness of intersex issues and genital modification specifically. </p>
<p>Shortly after this, twelve UN entities including the OHCHR, UNICEF and the World Health Organisation, <a href="http://www.ohchr.org/Documents/Issues/Discrimination/Joint_LGBTI_Statement_ENG.PDF">released a joint statement</a> condemning anti-LGBTI discrimination and violence. They specifically pointed out that LGBTI persons may face </p>
<blockquote>
<p>abuse in medical settings, including unethical and harmful so-called “therapies” to change sexual orientation, forced or coercive sterilization, forced genital and anal examinations, and unnecessary surgery and treatment on intersex children without their consent.</p>
</blockquote>
<h2>So, what about Australia?</h2>
<p>There is growing awareness in Australia of the potential human rights abuses on intersex children. </p>
<p>A 2013 federal senate inquiry into the <a href="http://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Community_Affairs/Involuntary_Sterilisation/Sec_Report/index">involuntary or coerced sterilisation</a> of intersex people found there is no medical consensus regarding how and when genital “normalising” surgery should be conducted. </p>
<p>Among the <a href="http://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Community_Affairs/Involuntary_Sterilisation/Sec_Report/b01">committee’s recommendations</a> was that all intersex medical procedures be managed by multidisciplinary teams in a human rights framework, and require authorisation by a court or tribunal. These recommendations did not lead to policy changes or legislative reform. </p>
<p>In 2016, Australian Human Rights Commissioner Ed Santow <a href="https://www.humanrights.gov.au/news/stories/intersex-rights-are-human-rights">endorsed international calls</a> to end medically unnecessary procedures to safeguard the human rights of intersex children. </p>
<p>In February 2017, the Rationalist Society of Australia – a secular free thought organisation – published its <a href="https://www.rationalist.com.au/campaigns/genital-autonomy-2/">white paper on genital autonomy</a>. This condemns all forms of medically unnecessary, non-consensual genital modification as violations of human rights. The white paper calls for the criminalisation of these procedures on equal footing with the prohibition of female genital mutilation.</p>
<p>Despite increasing international and national awareness of the human rights violations caused by genital modification procedures, Australia has not reformed its laws. Yet rights to bodily integrity and autonomy should be protected for all children. Until we safeguard every child from all forms of violence, opposition to genital cutting will not be an Australian value.</p><img src="https://counter.theconversation.com/content/76952/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Cornelia Koch is on the Advisory Board of the Australasian Institute for Genital Autonomy. </span></em></p><p class="fine-print"><em><span>Travis Wisdom is an associate member of Organisation Intersex International Australia Limited (OII-Australia) and is the co-author of the Rationalist Society of Australia white paper, 'Genital Autonomy.' </span></em></p>Until we safeguard every child from all forms of violence, opposition to genital cutting will not be an Australian value.Cornelia Koch, Senior Lecturer in Law, University of AdelaideTravis Wisdom, PhD Candidate, International Human Rights Law, University of AdelaideLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/718852017-02-08T18:55:59Z2017-02-08T18:55:59ZFemale genital mutilation is hurting Australian girls and we must work together to stamp it out<figure><img src="https://images.theconversation.com/files/155991/original/image-20170208-29025-jxo3lc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">By agencies working together, we can prevent female genital mutilation, which new research confirms is happening in Australia.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/549006412?size=medium_jpg">from www.shutterstock.com</a></span></figcaption></figure><p>Female genital mutilation or cutting is largely hidden in Australia and other high-income countries. Most people don’t consider it a major issue. But <a href="http://adc.bmj.com/content/early/2017/01/12/archdischild-2016-311540.full">our</a> <a href="http://www.sciencedirect.com/science/article/pii/S0145213416300382">research</a> <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4676087/">shows</a> it should be.</p>
<p>Our research found girls are presenting to paediatricians in Australia with female genital mutilation, but misconceptions about the practice are common and doctors want more information on how to manage this <a href="http://www.smh.com.au/nsw/first-person-to-be-imprisoned-over-female-genital-mutilation-in-australia-20160609-gpfm5i.html">illegal practice</a>.</p>
<p>Health professionals, lawyers, teachers, child protection authorities and communities at risk must be better informed. They must also work together to help prevent female genital mutilation, which contravenes declarations including the <a href="http://www.un.org/en/universal-declaration-human-rights/">UN Universal Declaration of Human Rights</a> and the <a href="https://www.unicef.org.au/Upload/UNICEF/Media/Our%20work/childfriendlycrc.pdf">UN Convention on the Rights of the Child</a>.</p>
<h2>What did we find?</h2>
<p>We <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4676087">found</a> health professionals worldwide are poorly informed about female genital mutilation: why it is performed, and its relationship to culture rather than religion.</p>
<p>Our <a href="http://www.sciencedirect.com/science/article/pii/S0145213416300382">survey</a> of Australian paediatricians, for instance, found 10% had ever seen a child with female genital mutilation; few knew the procedure was done outside Africa; few routinely asked about or examined girls for female genital mutilation; or understood the World Health Organisation (WHO) <a href="http://www.who.int/mediacentre/factsheets/fs241/en/">classification types</a>. Few had read local policy on how to manage girls presenting with female genital mutilation. Most had no relevant training and requested <a href="http://data.unicef.org/topic/child-protection/female-genital-mutilation-and-cutting/">educational resources</a>.</p>
<p><a href="http://www.sciencedirect.com/science/article/pii/S0145213416300382">Some paediatricians</a> had been asked to perform female genital mutilation, or for information about who would perform it. </p>
<p><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4676087/">Increasingly</a>, we are learning some immigrants to high-income countries, including Australia, may <a href="http://adc.bmj.com/content/101/3/212">have had the procedure or be at risk</a>. </p>
<p>Of the girls with female genital mutilation who Australian paediatricians had seen, all were from immigrant families, mostly from Africa, and seen in refugee clinics. Two children had female genital mutilation performed in Australia. One child born in Australia was taken to Indonesia for the procedure, a country where as many as <a href="http://data.unicef.org/topic/child-protection/female-genital-mutilation-and-cutting/">49% of girls</a> under the age of 14 years have had female genital mutilation.</p>
<h2>An ancient, global cultural practice</h2>
<p>Female genital mutilation is an ancient cultural practice, entrenched in some societies. It is often wrongly thought to be dictated by religion, yet is contained in the scriptures of none. Traditionally, female genital mutilation is practised in Africa, the Middle East and Asia. </p>
<p>In some countries (including Egypt, Somalia and Sierra Leone) it affects more than <a href="https://www.unicef.org/media/files/FGMC_2016_brochure_final_UNICEF_SPREAD(2).pdf">90% of the female population</a>.</p>
<p>UNICEF identifies female genital mutilation as a <a href="https://www.unicef.org/media/files/FGMC_2016_brochure_final_UNICEF_SPREAD(2).pdf">global concern</a>, estimating that over 200 million girls and women live with female genital mutilation. At current rates, 63 million more girls will have had the procedure by 2050.</p>
<h2>What is female genital mutilation?</h2>
<p>The World Health Organisation <a href="http://www.who.int/mediacentre/factsheets/fs241/en/">defines</a> female genital mutilation as:</p>
<blockquote>
<p>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. </p>
</blockquote>
<p>Procedures range from cutting or nicking the hood of the clitoris through to total removal of the clitoris and labia and sewing up the external opening (infibulation). Female genital mutilation does not include <a href="http://womhealth.org.au/conditions-and-treatments/genital-cosmetic-surgery">cosmetic procedures</a> such as labiaplasty that are increasingly popular in high-income countries. </p>
<h2>What are the consequences?</h2>
<p>Female genital mutilation is <a href="http://www.who.int/mediacentre/factsheets/fs241/en/">usually performed</a> in girls under 15 years old, and is often initiated by someone they trust, including family members, and conducted under non-sterile conditions, without pain relief. </p>
<p>Not surprisingly, female genital mutilation is associated with <a href="http://www.who.int/mediacentre/factsheets/fs241/en/">physical complications</a>, ranging from bleeding to urinary tract infection, incontinence, difficulties with menstruation, sexual problems, infertility and <a href="http://www.thelancet.com/journals/lancet/article/PIIS0140673606688053/abstract">complications during childbirth or for the newborn</a>. </p>
<p>But it is the <a href="http://www.nofgmoz.com/">psychological trauma</a> – post-traumatic stress disorder, flashbacks, anxiety and depression - that haunts many of the victims way beyond childhood and impacts their adult relationships.</p>
<p>Some women who have had female genital mutilation <a href="https://www.ted.com/talks/khadija_gbla_my_mother_s_strange_definition_of_empowerment">describe</a> it as child abuse, gender-based violence and gender discrimination, associated with a power play by men who want to control the lives of their wives and daughters. </p>
<h2>Ending female genital mutilation</h2>
<p>Several international agencies have called on female genital mutilation to be banned, including the <a href="http://www.undp.org/content/undp/en/home/sustainable-development-goals.html">UN</a> and its children’s agency <a href="http://www.unfpa.org/joint-programme-female-genital-mutilationcutting">UNICEF</a>. Although progress has been made towards ending female genital mutilation globally, <a href="http://www.unfpa.org/publications/unfpa-unicef-joint-programme-female-genital-mutilationcutting-accelerating-change">we have a way to go</a>.</p>
<p>We are aware that preventing this ancient cultural practice requires us to understand the complex motivation behind it. Although inherently risky, the procedure is entrenched in the social fabric of many communities. </p>
<p>As UNICEF <a href="https://www.unicef.org/protection/57929_58002.html">explains</a>:</p>
<blockquote>
<p>Communities practice [female genital mutilation or cutting] in the belief that it will ensure a girl’s proper upbringing, future marriage or family honour. In many contexts, the social norm upholding the practice is so powerful that families have their daughters cut even when they are aware of the harm it can cause.</p>
</blockquote>
<p>Nevertheless, UNICEF remains firm that no form of female genital mutilation be tolerated.</p>
<p>For us to end female genital mutilation, we need a multi-sectoral approach including education and empowerment of women to enable them, in partnership with men in their communities, to say “no” to female genital mutilation. </p>
<p>To do this, communities must be supported by health professionals and child protection authorities, underpinned by legislation banning female genital mutilation.</p>
<p>Unlike the United Kingdom, Australia has no national integrated female genital mutilation prevention policy linking health, education and community services. This should be a priority.</p><img src="https://counter.theconversation.com/content/71885/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Female genital mutilation is largely hidden in Australia and other high-income countries. But the United Nations says it is a global concern – and our research found it does affect girls here.Elizabeth Elliott, Professor of Paediatrics & Child Health and Director of the Australian Paediatric Surveillance Unit, University of SydneyYvonne Zurynski, Director of Research, Australian Paediatric Surveillance Unit and Associate Professor Discipline of Child and Adolescent Health, University of SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/721522017-02-06T16:13:40Z2017-02-06T16:13:40ZClaims female genital mutilation can have evolutionary benefits are unproven and potentially damaging<p>A new research paper has made the strange claim that female genital mutilation (FGM) can have an evolutionary benefit in societies where most women are subjected to the practice. FGM involves altering or injuring the female genitalia for non-medical reasons, and is internationally recognised as a <a href="http://www.unfpa.org/female-genital-mutilation">human rights violation</a>. Given that the new paper even starts by describing the harmful physical and psychological effects of the practice, how could the researchers claim FGM confers some sort of benefit in some cases?</p>
<p>The answer is supposedly tied up in the perceived social status of women who have and haven’t been cut in societies where FGM is the norm. This is typically in some or all ethnic groups in countries in northern Africa and the Middle East and in some communities elsewhere. The idea is that when most women in a society are subjected to FGM, those women will be more likely to marry and have children, and so pass on their genes. Conversely, in societies where most women don’t undergo FGM, it becomes a disadvantage for those who do. The evolutionary benefit goes to those women who follow the norm.</p>
<p>But we should be very careful about drawing such bold conclusions from what is actually very limited evidence, particularly when it could have a damaging effect on the <a href="http://www.unfpa.org/joint-programme-female-genital-mutilationcutting">international efforts</a> to eliminate FGM.</p>
<p><a href="http://nature.com/articles/doi:10.1038/s41559-016-0049">The new paper</a>, published in Nature Ecology & Evolution, is based on an analysis of data from the <a href="https://dhsprogram.com/">Demographic and Health Surveys</a>, which are standard questionnaire surveys undertaken in low and middle-income countries. The answers to the questions on FGM help monitor differences in the prevalence of FGM among women and their daughters by age, region of the country, ethnic group, educational level and religion and between urban and rural areas.</p>
<p>The researchers chose to study five countries in which there are different ethnic groups that have a high and low prevalence of FGM: Burkina Faso, Ivory Coast, Mali, Nigeria and Senegal. These are all in West Africa where the the less severe Type 1 and Type 2 <a href="http://www.who.int/mediacentre/factsheets/fs241/en/">forms of FGM</a> are typically practised. These involve removing part or all of the clitoris or inner labia, but not the narrowing of the vaginal opening by sewing up the outer labia.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/155656/original/image-20170206-18523-1ec6x98.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/155656/original/image-20170206-18523-1ec6x98.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=401&fit=crop&dpr=1 600w, https://images.theconversation.com/files/155656/original/image-20170206-18523-1ec6x98.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=401&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/155656/original/image-20170206-18523-1ec6x98.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=401&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/155656/original/image-20170206-18523-1ec6x98.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/155656/original/image-20170206-18523-1ec6x98.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/155656/original/image-20170206-18523-1ec6x98.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">This unproven claim could be damaging to international efforts to end FGM.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/lynnefeatherstone/12633470685/">Lynne Featherstone/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
</figcaption>
</figure>
<p>The data confirmed that FGM in these areas is what is known as a frequency-dependent behaviour. In other words, girls were more likely to be cut when their mothers were from ethnic groups with a high prevalence of FGM. This idea is already generally accepted, but the researchers also used the data to test a more controversial theory, that this frequency-dependent FGM is associated with evolutionary benefits.</p>
<p>The statistical analysis showed that in ethnic groups with a high prevalence of FGM, women who had been cut had more children surviving by the time they reached the age of 40. In contrast, in ethnic groups with low prevalences of FGM, women who were not cut had more surviving children. The researchers explained this by suggesting that women who conformed to the norms of their ethnic group (undergoing FGM or not) would be more likely to find marriage partners and have children, and have more resources to devote to raising them.</p>
<h2>Correlation not causation</h2>
<p>The problem is that these are statistical associations and are not necessarily causal. We don’t know for sure that undergoing FGM is what causes these women to have more surviving children in societies where the practice is prevalent. There may well have been other factors involved, such as access to maternity care at childbirth, to health care as children and levels of disease.</p>
<p>The paper also acknowledges that the data didn’t include women who had died in childbirth. The five chosen countries still have high maternal mortality rates and the women surveyed (aged 40 and over) would have started having children when mortality rates were even higher. <a href="http://www.who.int/gho/maternal_health/en/">Most notably</a>, in Mali, the rate fell from 1,100 maternal deaths per 100,000 live births in 1990 to 550 in 2010 and in Nigeria it fell from 1,200 to 560 over the same period. That means we don’t know how undergoing FGM affected the chances that women in these ethnic groups would die giving birth.</p>
<p>The analysis was based on only five countries but <a href="http://www.bristol.ac.uk/cmm/media/software/mlwin/downloads/manuals/2-36/manual-web.pdf">statisticians recommend</a> using at least 15 samples for this kind of multi-level modelling that involves several varying parameters.</p>
<p>There were also major differences between the countries examined. Mali and Burkina Faso were the countries with the highest prevalence of FGM among mothers. But in Mali the percentages of daughters who were also cut were almost as high as for the mothers, while in Burkina Faso they were substantially lower. Similar if less marked differences were seen in most of the ethnic groups in Senegal, Ivory Coast and Nigeria that had high prevalences of FGM among mothers. These differences call into question the validity of aggregating data from these countries to draw an overall conclusion</p>
<p>The researchers’ analysis was also based on a single survey from each country. In most countries, these surveys are repeated at three to five-year intervals and show that <a href="http://data.unicef.org/topic/child-protection/female-genital-mutilation-and-cutting/">the situation</a> in most but not all countries is changing over time, but at different rates. This means we should be wary of making generalisationsbaes on single points in time.</p>
<p>The claim that FGM provides evolutionary benefits in societies where it is the norm is an extraordinary one, and so it requires extraordinary evidence. Given the limits of the evidence provided by the researchers in this case, we have to say the claim is unproven.</p><img src="https://counter.theconversation.com/content/72152/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Alison Macfarlane receives funding from the National Institute for Health Research for a project on a different topic. She received funding from the Home Office and the Trust for London for research to estimate the prevalence of FGM in England and Wales.</span></em></p>A new study suggests women who undergo FGM in societies where it is prevalent have more surviving children – but the evidence isn’t strong enough.Alison Macfarlane, Professor of Perinatal Health, City, University of LondonLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/708242017-01-09T07:42:07Z2017-01-09T07:42:07ZIn Sudan, movies made by researchers change the way people see female genital cutting<figure><img src="https://images.theconversation.com/files/152104/original/image-20170109-23453-gbr27k.png?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Screenshot of a fiction movie researchers used to debate genital cutting among families they worked with in Sudan.</span> <span class="attribution"><span class="source">C.Efferson/Unicef-Sudan</span>, <span class="license">Author provided</span></span></figcaption></figure><p><a href="http://www.who.int/mediacentre/factsheets/fs241/en/">Female genital cutting</a> and the <a href="https://books.google.ch/books/about/Female_circumcision_in_Africa.html?id=rhhRXiJIGEcC&redir_esc=y">international response</a> surrounding the practice represent incompatible cultures coming together in a shrinking world. According to UNICEF, in 2016, an <a href="http://data.unicef.org/wp-content/uploads/2016/04/FGMC-2016-brochure_250.pdf">estimated</a> 200 million girls and women have been cut in 30 different countries. </p>
<p>Though an incomprehensible practice to some, cutting <a href="http://www.theatlantic.com/international/archive/2015/04/female-genital-mutilation-cutting-anthropologist/389640/">makes sense</a> to people socialised in practising cultures. Whatever one’s cultural background, however, cutting arguably represents a <a href="http://www.sjph.net.sd/files/Vol6N2/Brief%20Communications1.pdf">violation of universal human rights</a> that supersedes culture. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/151676/original/image-20170103-29222-34v0kl.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/151676/original/image-20170103-29222-34v0kl.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/151676/original/image-20170103-29222-34v0kl.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=273&fit=crop&dpr=1 600w, https://images.theconversation.com/files/151676/original/image-20170103-29222-34v0kl.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=273&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/151676/original/image-20170103-29222-34v0kl.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=273&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/151676/original/image-20170103-29222-34v0kl.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=343&fit=crop&dpr=1 754w, https://images.theconversation.com/files/151676/original/image-20170103-29222-34v0kl.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=343&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/151676/original/image-20170103-29222-34v0kl.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=343&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Female Genital Mutilation/Cutting worldwide.</span>
<span class="attribution"><a class="source" href="https://upload.wikimedia.org/wikipedia/commons/a/a1/2013_Female_Genital_Mutilation_Cutting_FGM_World_Map_UNICEF.jpg">UNICEF 2013/M Tracy Hunter/Wikimedia</a>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
</figcaption>
</figure>
<p>These alternate views place international agencies promoting the abandonment of cutting <a href="http://onlinelibrary.wiley.com/doi/10.1111/j.1548-1433.2008.00028.x/abstract">in a dilemma</a>, trapped between conflicting commitments to cultural tolerance and universal human rights.</p>
<p>This dilemma is exacerbated by the common view that cutting is a locally pervasive practice based on a <a href="https://books.google.ch/books/about/Female_circumcision_in_Africa.html?id=rhhRXiJIGEcC&redir_esc=y">deeply entrenched social norm</a>. An influential version of this view suggests that, where cutting is practised, families must match the local norm to ensure good marriage prospects for their daughters. When most families cut, under this view, incentives favour cutting. When most families do not cut, incentives favour not cutting. Incentives like this could be present because, for example, a family that deviates from the local norm is ostracised and hence their daughters cannot grow up to marry good husbands. </p>
<p>If correct, this view implies that abandoning cutting requires efforts that introduce or even impose foreign values onto a cutting society. </p>
<p>But a successful programme can change incentives in the marriage market by shifting a sufficiently large number of families away from cutting. Such a shift means that the incentives for families to coordinate with each other can switch from favouring cutting to favouring abandonment. Once this happens, the need for families to coordinate takes over and accelerates the process of abandonment.</p>
<p><a href="http://science.sciencemag.org/content/349/6255/1446">My colleagues and I</a> have been examining these ideas in Sudan, a country known for both a high overall cutting rate and extreme forms of the practice that bring risks of infection, haemorrhaging, and obstetric complications. </p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/uvz3nxqlnGs?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">UNICEF Saleema campaign in 2010 against female genital cutting. Source: UNICEF-Sudan.</span></figcaption>
</figure>
<p><a href="http://data.unicef.org/resources/female-genital-mutilation-cutting-country-profiles/">Much of Sudan</a> is estimated to have a cutting rate above 80% for women and girls aged 15-49. Infibulation, which involves removing large amounts of tissue and sewing the edges of the vulva and the wound closed so they heal to leave only a small opening, is also believed to be common. </p>
<p>What we have found may come as a surprise to some. Cutting is not always a deeply rooted norm, and it is possible to change attitudes towards the practice through the surprising medium of entertainment.</p>
<h2>Local diversity</h2>
<p>In direct contrast to the prevailing view of cutting, we have found that attitudes and practices vary tremendously over small areas. We have worked in dozens of farming communities along the Blue Nile in the state of Gezira, south of Khartoum.</p>
<p>We have found that communities consist of a thorough mix of cutting and non-cutting families, and a mix of people who are relatively positive and relatively negative about uncut girls. This finding has broad implications for both our understanding of why parents cut and how to promote the abandonment of cutting.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/151680/original/image-20170103-18665-11oco1v.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/151680/original/image-20170103-18665-11oco1v.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/151680/original/image-20170103-18665-11oco1v.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/151680/original/image-20170103-18665-11oco1v.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/151680/original/image-20170103-18665-11oco1v.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/151680/original/image-20170103-18665-11oco1v.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/151680/original/image-20170103-18665-11oco1v.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Changing parent’s views on female genital cutting might require new methods, here in Burkina Faso.</span>
<span class="attribution"><a class="source" href="https://commons.wikimedia.org/wiki/File:Changing_parents'_views_on_Female_Genital_Mutilation-Cutting_(FGM-C)_(12344755205).jpg">Jessica Lea/DFID</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span>
</figcaption>
</figure>
<p>We developed a number of methods for measuring attitudes and practices related to female genital cutting. One method was based on the fact that girls have henna applied to their feet the day they are cut, and this is the only circumstance in which a young girl would have henna on her feet. For the several weeks that henna remains on the toenails, it thus provides a reliable and easily observed indication that a girl has been recently cut. </p>
<p>We essentially counted girls with henna on their feet and combined these figures with other sources of data to estimate the prevalence of cutting in each community.</p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/151691/original/image-20170104-18679-19s3qjz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/151691/original/image-20170104-18679-19s3qjz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=903&fit=crop&dpr=1 600w, https://images.theconversation.com/files/151691/original/image-20170104-18679-19s3qjz.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=903&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/151691/original/image-20170104-18679-19s3qjz.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=903&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/151691/original/image-20170104-18679-19s3qjz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1135&fit=crop&dpr=1 754w, https://images.theconversation.com/files/151691/original/image-20170104-18679-19s3qjz.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1135&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/151691/original/image-20170104-18679-19s3qjz.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1135&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Toe nails painted with henna, Sudan.</span>
<span class="attribution"><span class="source">UNICEF Sudan/C.Efferson</span></span>
</figcaption>
</figure>
<p>With respect to both behaviour and attitudes, we developed our methods to minimise the risk that participants would simply tell us what they thought we wanted to hear. Henna on a girl’s foot, for example, provides a ready indication that a girl has recently been cut without a data collector having to ask the girl’s parents how they feel about cutting. </p>
<p>We also used implicit association tests: psychological measures that rely on reaction times and have been specifically designed to minimise the potential for respondents to misrepresent their attitudes.</p>
<p>Our results show that a diversity of views on genital cutting is not only present, but typical, in the area we studied. This is in direct contrast to the working assumption of international agencies that promote the abandonment of cutting. Put simply, cutting is not locally pervasive. Those who cut and those who do not are often neighbours.</p>
<p>We did find that in most communities, many people claim it is important for men and women who marry to come from families with the same cutting practices. Such a commitment to coordinated cutting practices in the marriage market could promote locally homogeneous attitudes and practices. </p>
<p>But this is reliably true only if families are similar in terms of the intrinsic value they place on cutting. Families might be similar in this way, for example, because they all have the same opinion about whether Islam requires cutting. Or perhaps all families have similar views about the health risks of cutting. </p>
<p>Families could be dissimilar because one family believes Islam requires cutting, while another does not. Or maybe one family is preoccupied with the health risks of cutting, and another family is not. </p>
<p>Policy-wise, this means that international agencies cannot initiate a process of behaviour change and then expect social pressure among families in the target population force to accelerate the process of giving up the practice.</p>
<h2>Changing attitudes with movies</h2>
<p>Local diversity came as a surprise to us, but it can be used to design a different kind of intervention. Accordingly, we produced four fiction feature-length movies that show an extended family in Sudan as family members arguing about whether to continue cutting.</p>
<p>In our films, some family members favour continuing the practice; others favour abandonment. Because the debate about cutting is strictly within an extended family, the films situate the antagonism between cutting and abandonment as locally as possible.</p>
<p>The four movies differ in terms of the types of arguments family members bring for and against cutting. One movie was a “control”. The control movie consists entirely of an entertaining main plot that does not address cutting in any way. The other three movies include 27-minute sub-plots that dramatise the family’s internal conflict about cutting. </p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/mv8hUUhkluE?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Opening scenes of “The Yard, (الحوش)”</span></figcaption>
</figure>
<p>One movie emphasises values. Some family members worry that cutting is necessary for the moral development of girls, for example, while others are preoccupied with the health risks. </p>
<p>Another emphasises the effect of cutting on the future marriage prospects of girls. Some family members speculate that their daughters will not grow up to find good husbands if they are not cut. Others argue that times are changing fast, and their daughters will not grow up to find good husbands if they are cut.</p>
<p>The third movie has a combined plot. It includes arguments based on values related to health, religion, and moral development, along with arguments based on how cutting affects marriage prospects. We used the four movies as treatments in two separate experiments. </p>
<p>In one experiment, we randomly assigned individuals within communities to watch one of the four movies, while in the other we randomly assigned entire groups of communities in a given area to watch one of the four movies. </p>
<p>We worked with around 8,000 randomly selected adults in 127 communities. We found that all three movies about cutting improved attitudes toward uncut girls, but one movie in particular produced relatively <a href="http://www.nature.com/nature/journal/v538/n7626/full/nature20100.html">persistent changes</a>. </p>
<p>The movie with the relatively persistent effect was the combined movie, that dramatises the full suite of arguments for and against cutting. In addition to the basic effects of the three movies about cutting, we also found that families with a history of nomadism and animal herding were more negative about uncut girls. Although somewhat speculative, this correlation could follow from the fact that families with a highly nomadic past place more value on cutting because it potentially increases certainty about the paternity of children. </p>
<p>Our research in Sudan has shown that cutting is not necessarily a pervasive and deeply entrenched norm. In our case, we produced movies that dramatise a Sudanese family grappling with its own internal conflict about whether to continue cutting. </p>
<p>Using a measure of implicit attitudes, we found that these movies significantly improved people’s view of uncut girls. Like other <a href="http://didattica.unibocconi.it/mypage/upload/49273_20160519_034132_564.PDF">recent studies</a> showing that entertainment can change attitudes and specifically reduce gender bias, our results show that entertainment can lay the groundwork for socially beneficial behaviour change.</p><img src="https://counter.theconversation.com/content/70824/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Charles Efferson has received funding from the Swiss National Science Foundation, the U.S. Environmental Protection Agency, and the Swiss National Committee of UNICEF. </span></em></p>In Sudan, female genital cutting is common among many communities. The use of movies that debate this question could change people’s opinions about the practice.Charles Efferson, Senior Researcher, University of ZurichLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/637872016-08-18T20:43:00Z2016-08-18T20:43:00ZCultural practices that affect children’s health must be revisited<figure><img src="https://images.theconversation.com/files/134138/original/image-20160815-14909-13ioora.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Pokot girls in Kenya wait for an ceremony that marks their passage into womanhood -- and means they're ready for marriage.
</span> <span class="attribution"><span class="source">Reuters/Siegfried Modola</span></span></figcaption></figure><p>International broadcaster BBC has released a <a href="http://www.bbc.com/news/magazine-36843769">gripping exposé</a> about a Malawian man who explained how he initiates young girls into sexual activity as part of a rite of passage. </p>
<p>The man, informally known as a hyena, is alleged to be one of many in a southern Malawian community who are paid to perform the service. One of the most startling revelations is that, by his own admission, the man is living with HIV but does not use condoms when he has sex with these girls. </p>
<p>The report serves as a stark reminder of children’s extreme vulnerability.</p>
<p>Since the broadcast, Malawi’s President Peter Mutharika has <a href="http://www.nyasatimes.com/president-mutharika-orders-arrest-hiv-infected-man-paid-devirginise-girls-malawi-nonsense-hyena-culture-must-stop/">spoken out</a> against harmful cultural practices. The “hyena” has since been arrested. But the question remains: does taking on one hyena clean the ecosystem? What about the families, mothers, fathers and relatives who played a role?</p>
<p>The reality is that despite high levels of knowledge and information, communities still adhere to cultural practices which endanger their children. </p>
<h2>Persistent traditions and cultural practices</h2>
<p>The Malawian rite of passage is just one example where communal mores and norms are reinforced by communities. Several <a href="http://www.unicef.org/aids/files/Vulnerability_young-women-and-girlsSAfrica_2008_UNAIDS.pdf">studies</a> by UNICEF, UNAIDS and the Global Commission on HIV and the Law have shed light on African cultures and traditions associated with the human life cycle. These include initiation, birth and death rites; arranged marriages, female genital mutilation, circumcision and various iterations of cleansing rituals associated with the body and mind.</p>
<p>But some of these other cultural and ritual practices have come under scrutiny because they violate the health and rights of individuals. And in most cases it is children and women who bear the brunt.</p>
<p>This happens in many ways:</p>
<ul>
<li><p>young girls are forced into early sexual debut and unprotected sex and are at risk of contracting HIV;</p></li>
<li><p>female genital mutilation causes health complications for girls and women around sexual health and pregnancy;</p></li>
<li><p>child marriages result in childbearing which often has negative effects on their health and the child they carry;</p></li>
<li><p>In settings of poverty, many of these children suffer from malnutrition. This complicates maternal and child health; and,</p></li>
<li><p>In the long term, many of these women have poor physiological and mental health outcomes. </p></li>
</ul>
<p>In addition, these rituals are often transactional. Where there are high levels of poverty these children become a “resource”. They are transacted for money, food or other material goods. The main benefactors are adult males who seek to enhance their status or to get another wife. These men also look for labour or consider such girls a medical solution – some maladies are believed to need a young virgin “girl” for cleansing.</p>
<p>It has been shown that addressing the HIV epidemic in southern Africa is hampered by practices which place young people, particularly young women and girls, at risk of infection. </p>
<p>The question is why some of these cultural practices persist in the face of so much effort and interventions to highlight their negative impacts on individuals and communities. For example, three decades of HIV/AIDS and broader public health research has shown the link between unsafe ritual practices and human health and development. </p>
<h2>Legal instruments only go so far</h2>
<p>Several legal mechanisms have been put in place to tackle violence against children. </p>
<p>SADC leaders have approved a model law to ban child marriages and other forms of violence against children. They are also reviewing the SADC Gender Protocol which among other things prioritises the implementation of <a href="http://genderlinks.org.za/">gender equality</a>. <a href="http://www.girlsnotbrides.org/region/sub-saharan-africa">Female genital mutilation</a> and marriages involving children are banned in <a href="http://www.who.int/reproductivehealth/topics/fgm/prevalence/en/">several African countries</a>. But the practices continue.</p>
<p>At a regional level, the African Union has given significant attention to the issue of women’s empowerment. It has pronounced on gender based violence and child marriages as part of its Agenda 2063, the continental development road map. </p>
<p>There are also other international instruments like the UN Convention on the Rights of the Child, which most countries across the globe have signed up to. Several other high level international forums convened by United Nations agencies have similarly prioritised gender based violence and launched high profile <a href="http://wps.unwomen.org/en">initiatives</a> to promote the safety and security of women and girls. One of their most recent initiatives is the <a href="http://www.mckinsey.com/global-themes/women-matter">#womenmatter (Africa) McKinsey report</a>, launched by the Executive Director of UN Women Phumzile Mlambo-Ngcuka.</p>
<p>But the challenge is that none of these initiatives address the complicity and collusion of people, families and communities. Nor do they tackle how children and young people are silenced.</p>
<h2>What more can be done?</h2>
<p>Institutions that work with children and youth must be better equipped and protected in executing their mandate. Their work is too often hampered by <a href="http://www.girlsnotbrides.org/">mixed messages</a> from communities and leaders </p>
<p>More laws are needed because many countries have dual or multiple legal systems where these practices are not criminal. </p>
<p>Political leaders must be less ambivalent about legal reforms which they believe irk their largely rural voters in whose backyards most of these cultural practices thrive. </p>
<p>There are several groups that need to engaged to tackle culture related violence on children.</p>
<p>Working with elders who are gatekeepers of culture and tradition is critical in navigating for firm and purposeful action.</p>
<p>Tackling silences and rituals protecting patriarchal impunity must also involve engaging cultural experts and practitioners. </p>
<p>Finding ways to engage children is also important. Often children are not listened to until harm has been done. </p>
<p>Africa must prioritise its youth if the development aspirations of the global Sustainable Development Goals 2030 and Agenda 2063 are to to be realised. Preserving African cultures and traditions is important. But it should not translate into a license for murder.</p><img src="https://counter.theconversation.com/content/63787/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Alinah Kelo Segobye received funding from the Rotary Peace Centre, Peace Studies Department as a visiting scholar at the University of Bradford in 2016. </span></em></p>Despite high levels of knowledge and information, communities still adhere to cultural practices which endanger their children.Alinah Kelo Segobye, Associate Professor (Archaeology), University of South AfricaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/543792016-02-16T02:13:21Z2016-02-16T02:13:21ZFemale genital cutting common in Indonesia, offered as part of child delivery by birth clinics<figure><img src="https://images.theconversation.com/files/111451/original/image-20160215-22563-1et1ldn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">More than 80% of female circumcision in Indonesia are performed on babies under 1-year-old. </span> <span class="attribution"><span class="source">Hanie Spalie/www.shutterstock.com</span></span></figcaption></figure><p><a href="http://www.who.int/mediacentre/factsheets/fs241/en/">Female genital mutilation (FGM)</a>, an ancient tradition of cutting, scraping, piercing or nicking of genitals of young girls, was believed to be practised predominantly in sub-Saharan Africa and the Middle East. But a recent <a href="http://www.unicef.org/media/files/FGMC_2016_brochure_final_UNICEF_SPREAD.pdf">report</a> by the United National Children’s Fund revealed that it is also common in Indonesia. </p>
<p>Around 60 million women, or half of the women in Indonesia, the world’s most populous Muslim majority, are estimated to have undergone FGM. </p>
<p>Traditional “circumcisers” have long carried out the practice, known as female <em>khitan</em> or <em>sunat perempuan</em> in Indonesia. In recent years, medical practitioners have been increasingly performing FGM, institutionalising the ritual into medical practice. </p>
<p>Many maternity clinics now offer the procedure as part of a birth delivery package, done soon after labour, without additional charges. </p>
<h2>Why female circumcision is common in Indonesia</h2>
<p>In Indonesia, people perceive circumcision as a required act of faith and part of tradition. A majority of Muslims in Indonesia follow the <a href="https://en.wikipedia.org/wiki/Shafi%27i">Shafi'i school</a> that obliges circumcision for boys and girls. </p>
<p>Indonesia tried to ban the practice in 2006. But religious clerics reacted by releasing an edict declaring that it was part of a religious practice. In 2010, the Indonesian Health Ministry <a href="http://www.hukor.depkes.go.id/uploads/produk_hukum/PMK%20No.%201636%20ttg%20Sunat%20Perempuan.pdf">released a regulation that allowed medical personnel to perform female genital cutting</a> on young girls. </p>
<p>The argument supporting medicalisation of FGM is that it is better to have trained medical personnel perform the procedure than risking severe infections if performed by traditional circumcisers. </p>
<p>However, medicalisation may actually be even more dangerous. Midwives tend to use scissors instead of penknives. Hence, they actually conduct real cutting of the skin. Traditional circumcisers, meanwhile, use penknives for more symbolic acts of scraping or rubbing.</p>
<p>In 2014, the Ministry lifted the regulation. However, medical establishments continue to carry out the procedure. Female genital cutting is now more commonly performed by medical personnel than traditional circumcisers. </p>
<p>In a <a href="http://www.popcouncil.org/uploads/pdfs/poster/frontiers/reports/Indonesia_FGM.pdf">2001-2002 Population Council Indonesia study on female circumcision</a>, of the 2,215 reported cases, 68% was performed by traditional birth attendants and traditional circumcisers. The remaining 32% was performed by medical personnel, mostly midwives. </p>
<p>The <a href="http://www.depkes.go.id/resources/download/general/Hasil%20Riskesdas%202013.pdf">2013 National Basic Health Survey (Riskesdas)</a> shows medical personnel perform more than half or 53.2% of reported FGMs. Of that percentage, 50.9% were done by midwives, 2.3% by other medical personnel. Meanwhile, traditional birth attendants or circumcicers perform 46.8% of FGMs. </p>
<h2>Performed on babies</h2>
<p>The 2001-2002 study showed that 85.2% of FGMs was performed before girls reach the age of nine. The 2013 survey showed the age to be going down: 96.7% of FGMs were performed before the age of five years. Of that, 82.8% were performed on babies between the ages 0 and 11 months. </p>
<p>The majority of those who had undergone FGM could not remember the process or pain when asked as adult respondents. Consequently, there was no evidence of immediate or long-term physical or psychological complications. </p>
<p>Nevertheless, direct observation of FGM procedures in 2001-2002 showed that it certainly involves pain, rubbing and scraping (24.3%). There was real genital cutting (49.2% incision and 22.4% excision). There was also stretching (3%) and a small proportion of pricking and piercing (1.1%).</p>
<h2>Parents’ wish</h2>
<p>The 2001-2002 study showed that 92% of interviewed parents wanted the practice to continue. This data came from eight districts in six provinces: West Sumatra, Banten, East Kalimantan, East Java, Gorontalo, and South Sulawesi. Those parents not only want their daughters to undergo circumcision but also their future grandchildren. </p>
<p>The 2013 National Basic Health Survey showed most parents (90%-94.9%) have similar wishes in nine provinces in Indonesia, including Aceh, East Kalimantan, most of Sulawesi and Gorontalo, as well as Maluku and North Maluku. The other 24 provinces in Indonesia showed lower percentages. </p>
<h2>Different from Africa?</h2>
<p>It is difficult to compare practices of female genital mutilation or cutting in Africa with those in Indonesia and it should be done with caution. </p>
<p>The 2001-2002 Population Council study shows that much of traditional circumcision in Indonesia is limited to scraping, rubbing and piercing with a needle to produce a drop of blood. </p>
<p>In contrast, in Africa the practice frequently involves partial or total removal of the clitoris (or the prepuce) and stitching to narrow the vaginal opening (infibulation).</p>
<p>Of the <a href="http://www.who.int/reproductivehealth/topics/fgm/overview/en/">1997 WHO types of female circumcision classification </a>, the practice in Indonesia is referred to the “unclassified type” or Type IV: </p>
<blockquote>
<p>“All other harmful procedures to the female genitalia for non-medical purposes”.</p>
</blockquote>
<h2>Human Rights</h2>
<p>Nevertheless, any form of female genital mutilation is unacceptable. </p>
<p>That it is done without the consent of the baby or little girl and without clear health benefits or religious mandate is enough to classify this act as a violation of human and health rights of the girl child. </p>
<p>The World Health Organisation (WHO) stated clearly in 1997 that female genital mutilation must not be institutionalised, nor should any form of genital cutting is performed by any health professionals in any setting or health establishments. </p>
<p>By allowing doctors, midwives and nurses to perform FGM, the Health Ministry has wrongly legitimised the practice as medically sound, and thus further institutionalising the practices in Indonesia. </p>
<p>Indonesia should stop the medicalisation of FGM. The government should carry out a campaign that informs the public that female circumcision is not obligatory under Islamic law. The government should also update the pre-service midwifery training curricula.</p><img src="https://counter.theconversation.com/content/54379/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Meiwita Budiharsana does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Female genital mutilation have long been carried out by traditional circumcisers in Indonesia. In recent years, the ritual has been increasingly institutionalised into medical practice.Meiwita Budiharsana, Lecturer, Faculty of Public Health, Universitas IndonesiaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/255112014-04-14T05:00:11Z2014-04-14T05:00:11ZBritain’s first FGM prosecution is all too politically convenient<p>On 21 March, the Crown Prosecution Service announced the <a href="http://www.bbc.co.uk/news/uk-26681364">first prosecution</a> of a person accused of female genital mutilation (FGM) in the UK. Dr Dhanuson Dharmasena, a doctor at the Whittington Hospital in London, will be prosecuted under <a href="http://www.legislation.gov.uk/ukpga/2003/31/section/1">Section 1(1)</a> of the Female Genital Mutilation Act (2003). </p>
<p>Dr Dharmasena is accused of re-stitching a women’s vagina at her request after she gave birth. The nature of this prosecution has widely been discussed and criticised – but the significance of the announcement’s timing seems to have been overlooked.</p>
<p>The United Nations special rapporteur on violence against women, <a href="http://www.ohchr.org/en/Issues/Women/SRWomen/Pages/RashidaManjoo.aspx">Rashida Manjoo</a>, began an official visit to the UK on 31 March. Her visit came on the back of a highly critical <a href="http://www.scottishhumanrights.com/application/resources/documents/ConcObsCEDAW.doc">report</a>, published by the UN Committee on the Elimination of Discrimination Against Women (CEDAW) in July 2013, which highlighted the UK’s failure to progress on many issues pertaining to violence against women. </p>
<p>Accordingly, the government wants to demonstrate that it’s taking violence against women seriously, and implementing strategies that will initiate real change. FGM laws have existed in this country since 1985, yet this first prosecution was only announced last month. The <a href="http://blog.cps.gov.uk/2014/03/cps-announces-first-prosecutions-for-female-genital-mutilation.htmlhttp://blog.cps.gov.uk/2014/03/cps-announces-first-prosecutions-for-female-genital-mutilation.html">announcement</a> was made by the director of public prosecutions, guaranteeing it significant media attention. Tellingly, the event occurred just ten days before the UN expert’s visit – raising questions about the motivations behind it.</p>
<p>Recall that in August 2013, the UK was visited by another UN special rapporteur, <a href="http://www.theguardian.com/society/patrick-butler-cuts-blog/2014/feb/03/bedroom-tax-raquel-rolnik-uncomfortable-housing-truths">Raquel Rolnik</a>, whose remit covers the right to adequate housing. The government and media response to her visit has widely been criticised by other countries and by the UN. Rather than taking on board the <a href="http://dpac.uk.net/wp-content/uploads/2014/02/A_HRC_25_54_Add.2_ENG.doc?5e9610">report</a> and recommendations, the British government and media sought to undermine her with personal and professional <a href="http://www.dailymail.co.uk/news/article-2418204/Raquel-Rolnik-A-dabbler-witchcraft-offered-animal-sacrifice-Marx.html">slights</a>. </p>
<p>Clearly, a different strategy is being adopted for Rashida Manjoo. Almost no media attention has been given to her visit – other than a short Daily Mail <a href="http://www.dailymail.co.uk/news/article-2596567/Now-UN-probes-violence-against-women-UK-Ministers-fear-review-Governments-response-lead-demands-radical-new-laws.html">article</a> – and there has been no prominent government comment. Violence against women is a major concern in this country, and has been the subject of various recent public campaigns. Following on from the CEDAW report that identified forced marriage, domestic violence, rape convictions, “honour killings”, and a specific recommendation that the CPS “effectively prosecute” FGM, The Guardian newspaper, among others, has undertaken <a href="http://www.theguardian.com/society/female-genital-mutilation">extensive investigative journalism</a> to highlight these issues. </p>
<p>These campaigns are backed by a wide spectrum of activists, academics, and human rights charities and have emphasised the government’s role in undermining systems for protecting women. This has included <a href="http://www.opendemocracy.net/5050/heather-mcrobie/austerity-and-domestic-violence-mapping-damage">cutting funding</a> for women’s shelters, failure to address <a href="http://www.rapecrisis.org.uk/news_show.php?id=41">low prosecution rates for rape</a>, the high rate of <a href="http://www.theguardian.com/society/2014/feb/26/domestic-violence-risk-death-injury-police">domestic murder</a> and the inadequacy of FGM and forced marriage laws. Undoubtedly, all of this attention, combined with Rashida Manjoo’s visit, has played a significant role in the decision to prosecute Dharmasena for FGM now, and to make the case a major public issue.</p>
<h2>Get real</h2>
<p>But the government’s strategy is not simply about engaging with UN experts. The announcement of this prosecution ties in with the government’s broader strategies to appeal to female voters. The main political parties are locked in a <a href="http://www.theguardian.com/politics/2013/feb/14/tories-women-spotlight-female-vote">battle</a> for women’s votes. A range of measures designed to appeal to UK women have been promoted during the current parliament, including the <a href="http://www.telegraph.co.uk/technology/internet/10194641/Camerons-crackdown-on-illegal-pornography-criticised.html">crackdown on porn</a>, increased levels of <a href="https://www.gov.uk/government/news/millions-of-parents-to-get-help-with-childcare-costs">childcare support</a>, and the provision of <a href="http://www.bbc.co.uk/news/uk-politics-24132416">free school meals</a> for infants. David Cameron has <a href="http://www.dailymail.co.uk/news/article-2421027/David-Camerons-problem-women-Female-voters-desert-Tories-PM-posh-touch.html">advisors</a> dedicated to devising “women-friendly” policies. </p>
<p>Yet all of this is taking place against a background of significant criticism of the <a href="http://www.telegraph.co.uk/news/politics/10731754/We-need-more-women-in-the-Cabinet-Baroness-Warsi-tells-David-Cameron.html">weak representation</a> of women in the cabinet, and the heavy <a href="http://inherentlyhuman.wordpress.com/2013/10/29/an-economic-crisis-for-women/#more-1532">burden</a> women are bearing in the face of austerity measures.</p>
<p>The prosecution of Dharmasena might be seen as a tentative step forward in terms of addressing a very real problem of FGM within the UK, but it seems likely that it was also a good opportunity to make a political point, rather than a real reflection of systematic change. The UN rapporteur should be expected to see through this. During her visit, Manjoo has met and hosted teleconferences with government officials, grassroots organisations and victims of gender-based violence. Her preliminary report is due on April 15; it is unlikely to be swayed by well-timed headlines over and above the concerns of the women and campaigners she has met. </p>
<p>It is telling that the government has failed to address the significant structural problems that contribute to these issues and instead has resorted to tokenism. It has been left to the former head of the CPS, Kier Starmer, to <a href="http://www.bbc.co.uk/news/uk-25647046">launch</a> a political campaign seeking more prosecutions for violence against women, because he was unable to secure these changes while in his former job.</p>
<p>Meanwhile, domestic violence is <a href="http://www.womensaid.org.uk/domestic-violence-press-information.asp?itemid=3194&itemTitle=Women%92s+Aid+warns+of+crisis+in+domestic+violence+services&section=0001000100150001&sectionTitle=Press+releases">estimated</a> to affect 1.2m British women per year, and well over 10,000 women live at <a href="http://www.theguardian.com/society/2014/feb/26/domestic-violence-risk-death-injury-police">high risk</a> of death or serious injury at the hands of their partners. <a href="http://www.womensaid.org.uk/domestic_violence_topic.asp?section=0001000100220036">Two women</a> are killed per week at the hands of a current or former partner, yet <a href="http://www.telegraph.co.uk/women/womens-life/10489265/Domestic-violence-death-toll-will-rise-due-to-funding-cuts.html">funding cuts</a> to specialist domestic violence services threaten to worsen the situation further. The number of girls at risk of FGM in the UK is <a href="http://www.nhs.uk/conditions/female-genital-mutilation/Pages/Introduction.aspx">estimated</a> to be at 20,000 per year, yet only one prosecution has been announced.</p>
<p>If the government wants to win the support of the UN special rapporteur, and of female voters, it will have to do better than media posturing.</p><img src="https://counter.theconversation.com/content/25511/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Rosa Freedman receives funding from the British Academy</span></em></p><p class="fine-print"><em><span>Ben Warwick is affiliated with human rights NGOs, Restless Beings and the Center for Economic and Social Rights.</span></em></p>On 21 March, the Crown Prosecution Service announced the first prosecution of a person accused of female genital mutilation (FGM) in the UK. Dr Dhanuson Dharmasena, a doctor at the Whittington Hospital…Rosa Freedman, Lecturer in Law, University of BirminghamBen Warwick, Graduate Teaching Assistant and PhD candidate, Durham UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/148672013-06-13T05:46:20Z2013-06-13T05:46:20ZUK letting down victims of female genital mutilation<figure><img src="https://images.theconversation.com/files/25432/original/mpxhmkx9-1371058532.jpg?ixlib=rb-1.1.0&rect=1%2C3%2C1119%2C761&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Female genital mutilation is happening in the UK.</span> <span class="attribution"><span class="source">London Safeguarding Children Board</span></span></figcaption></figure><p>Female genital mutilation (FGM) is happening across the UK but despite being illegal for nearly 30 years, there have been no convictions. </p>
<p>Fortunately, politicians are beginning to pick up on the issue. A report from a committee of MPs <a href="http://www.parliament.uk/business/committees/committees-a-z/commons-select/international-development-committee/news/vawg-report-substantive/">warned that</a> the UK “is weakened by its failure to address [FGM] violence within its own borders”. They say it’s “unforgiveable” that there hasn’t been a single prosecution since the procedure was made illegal here in 1985. </p>
<p>FGM is a deep rooted traditional practice that has a huge impact on the health and well being of millions of girls and young women around the world. It’s a common practice in 28 African countries, as well as parts of the Middle East and Asia. In some countries such as Djibouti and Mali, <a href="http://www.who.int/bulletin/volumes/86/4/07-042093/en/">more than 90% of women</a> are believed to have undergone FGM. In Egypt it is illegal but the country still has one of the highest rates in the world. Only recently, <a href="http://www.huffingtonpost.com/2013/06/10/suhair-al-bataa-13-year-old-dies-circumcised_n_3417528.html">13-year-old Suhair al-Bata</a> died after undergoing the procedure in a village north of Cairo.</p>
<p>But FGM is not restricted to these countries. Globalisation and ease of travel means many Africans migrating to the EU and other developed regions - for economic reasons or asylum - has spread the practice. FGM is now taking place in EU countries and is <a href="http://www.europarl.europa.eu/sides/getDoc.do?type=TA&language=EN&reference=P7-TA-2012-261">on the increase</a>. </p>
<p>In England and Wales it’s estimated that 66,000 women are already living with FGM and a further 21,000 girls are <a href="http://www.nhs.uk/Conditions/female-genital-mutilation/Pages/Introduction.aspx">at risk of being cut</a>.</p>
<p>Anecdotal evidence collected as part of <a href="http://replacefgm.eu/sites/default/files/pressroom/REPLACE%20Toolkit.pdf">our research</a> suggests that some EU citizens are moving between member states to take advantage of differences in legislation - making the UK a destination for many families who want FGM for their daughters and believe the law isn’t applied here.</p>
<h2>What is FGM?</h2>
<p>FGM involves removing part or all of the external parts of a girl or woman’s genitalia but <a href="http://www.who.int/mediacentre/factsheets/fs241/en/">also includes procedures</a> that cause injury to that part of the body for cultural or other non-therapeutic reasons. The UN regards the practice of FGM as a violation of human and female reproductive health rights. Many <a href="http://www.unicef.org/protection/57929_58002.html">now recognise it</a> as a form of violence against girls and women and further, a form of torture. </p>
<p>The ritual is usually performed by traditional practitioners who have no formal medical training and perform the operation in non-sterile conditions. It can cause serious physical harm such as complications in childbirth, excessive bleeding, blood poisoning, death and HIV transmission, and psychological damage.</p>
<p>The World Health Organisation classifies FGM into four types. Type III is the most serious kind and often involves women <a href="http://www.who.int/mediacentre/factsheets/fs241/en/">having to be cut open</a> again to have sexual intercourse and for childbirth. It’s <a href="http://www.who.int/reproductivehealth/topics/fgm/prevalence/en/">estimated that globally</a> 90% of women affected by the practice have been subjected to full or partial removal of their clitoris and/or the removal of their inner labia and other “unclassified” procedures, including the use of cauterisation. </p>
<h2>Where did FGM come from?</h2>
<p>The <a href="http://www.unicef.org/protection/57929_58002.html">origins of FGM are unknown</a>; it doesn’t appear to be connected to any particular religion or culture, but perpetuated over generations by social dynamics. </p>
<p>It is often defended as a rite of passage from girlhood into womanhood and usually performed on girls from babyhood up until the age of 15. Support comes directly from mothers, mothers-in-law, and elder women. But FGM isn’t “women’s business” as it’s often seen. All the communities where it is common are highly patriarchal. And men wield a lot of influence - indirectly from fathers, religious and community leaders. </p>
<p>Pain is an important element of the ritual that it is said prepares girls for the pain of childbirth - even though it can cause later complications. Sometimes FGM is performed for “purity” or “hygiene” and some people also believe, wrongly, that FGM is just a female version of male circumcision.</p>
<h2>Overcoming cultural barriers</h2>
<p>At Coventry University we headed up <a href="http://www.replace%20fgm.eu">two European-funded projects</a>: one looking at Somali and Sudanese communities in the UK and Holland and another, which has just started, at different African FGM practising communities across six EU countries.</p>
<p>It’s clear that we need to get away from cloaking FGM in medical terminology. Many practising communities also have their own definitions and language for the procedure which are difficult to relate to the WHO’s “type” classifications. Various differences that individuals and communities place on certain terminology make it extremely difficult to work out the various types of genital cutting and how often it happens.</p>
<p>Many people in the communities that we worked with don’t regard FGM as “mutilation” so that can lead to confusion about what type of cutting is covered by legislation. Many find the term FGM offensive and equate it with the worst kind of procedures, which we’ve found many don’t support. Using the term “sunna”, which loosely equates with FGM types I and II, can be better. </p>
<h2>We need more information</h2>
<p>In the 1990s, 14 African countries including Ethiopia, Uganda, Ghana, Senegal and Togo, together with Egypt and Djibouti and six of the Federal States in Nigeria effectively banned FGM. But today, there is little evidence the situation is changing. Practising communities in the UK are from countries where FGM is common and include Somalian, Sudanese, Gambian and Nigerian communities.</p>
<p>But we still lack information. Only <a href="http://www.who.int/reproductivehealth/topics/fgm/fgm_prevalence_egypt/en/">in Egypt</a> and Sudan is some data available to properly work out trends. For example, we know that there was a decline in FGM from 96% of women in 1979 <a href="http://www.childinfo.org/files/fgmc_Coordinated_Strategy_to_Abandon_FGMC__in_One_Generation_eng.pdf">to 89% in 1990 in Sudan</a>. This was accompanied by a 10% shift from the worst type of FGM to a less drastic form.</p>
<p>In Egypt, surveys showed that <a href="http://measuredhs.com/Who-We-Are/News-Room/Female-circumcision-decreasing-among-young-women-in-Egypt.cfm">girls are now less likely</a> to be cut than their mothers. Some credit urbanisation and increased access to education for girls as partly responsible; others suggest that the high international profile of the practice and the criminalising of the practice in some countries have also played a role.</p>
<p>But elimination of FGM is proving very difficult. Despite campaigns to explain to communities the health implications of the rite and the criminalisation of the practice in many countries, FGM has continued. The link between social structures and gender power relations and sexuality mean it’s very resistant to change. The failure to conform can affect how well a girl marries and her family’s standing. Turning against it can lead to social exclusion, ostracism or even violence. </p>
<p>Family honour and social expectations play a powerful role in perpetuating FGM, making it extremely difficult for individual families, as well as individual girls and women, to stop the practice on their own.</p>
<p>This is also true of the UK; it’s clear that pressure from the community makes it hard for people to go against it. To tackle the problem we need not just to change the behaviour of individual people, for example those doing the cutting, but tackle wider issues concerning the beliefs held by the community that perpetuate the practice making it ‘normal’.</p>
<p>Ending FGM in the UK is going to take time, but understanding more about it and taking new approaches to change individual and community behaviour will push us towards the tipping point that we need - when communities accept that FGM is no longer necessary or acceptable and individuals (parents and children) have the power to say no.</p><img src="https://counter.theconversation.com/content/14867/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Hazel Barrett receives funding from European Commission's Daphne III programme</span></em></p>Female genital mutilation (FGM) is happening across the UK but despite being illegal for nearly 30 years, there have been no convictions. Fortunately, politicians are beginning to pick up on the issue…Hazel Barrett, Associate Dean for Applied Research, Coventry UniversityLicensed as Creative Commons – attribution, no derivatives.