Eliminating Female Genital Cutting: Outlining “Eradication” Strategies and Efforts

In the 1970s, Western activist Fran Hosken framed FGC as a public health problem that needed to be “eradicated.” This medical approach has been criticized for its pathologizing terminology and medical generalizations. More recently, the World Health Organization and United Nations conferences have framed FGC in terms of “human rights” and “violence against women.”

Cultural Relativism vs. Universalism

The human rights approach encompasses four approaches: the rights of the child, freedom from torture, the right to health and bodily integrity, and the rights of women. The human rights approach faces an ongoing tension between universalism and cultural relativism; tension exists over who has the moral authority to condemn FGC. Universalists believe every individual has fundamental human rights that cannot be violated without legislative punishment, while cultural relativists believe one cannot impose their moral values on other cultures.

Women’s Rights

Today, indigenous women’s organizations often work with outside funders to eliminate FGC. However, not all African women welcome Western intervention, nor do they have identical priorities matching Western feminists. In 1980 the Association of African Women for Research and Development (AAWORD) criticized Western campaigns for ignoring the context of African women’s struggles against oppression. AAWORD stressed African women’s leadership and participation as crucial to eliminating FGC.

Medicalization

The “health and bodily integrity” approach encompasses the medicalization debate. Medicalization exists on a spectrum—from minimal to invasive medical intervention, from encouraging traditional circumcisers to use antibiotics, clean razors, local anesthesia, and milder FGC forms, to allowing doctors perform FGC in clinics and hospitals. While the right-to-health campaigners argue the adverse health effects of FGC, they often reject any efforts to provide medical support to minimize FGC health risks.

This debate poses numerous questions: Will medicalization condone/institutionalize or interfere/hinder efforts to eliminate FGC? Will some degree of medicalization lessen health risks and improve female health? Is female health sacrificed when campaigns reject medicalization as a step towards elimination? Does clinicalization change the complex political, economical, and social structures that oppress women? What happens to female agency when male doctors take over the practice from traditional female circumcisers?

Legislation

Western nations and African countries are increasingly criminalizing FGC. However, legislation outlawing FGC practices has been difficult to enforce in Africa, and some activists fear the practice will be driven underground. While some activists say punishment will eliminate FGC, others stress education.

In the U.S., immigration and asylum issues have arisen concerning immigrant groups who practice FGC. In 1996 a U.S. bill made it illegal to circumcise females under the age of 18. Two American asylum cases (Kassindja and Abankwah) set legal precedents for FGC within asylum law, but these cases also exposed uneven playing fields between the U.S. court system and the African women seeking asylum.

Other Approaches

The “development and modernization” approach theorizes that larger social changes, such as improvements in women’s education and socioeconomic status, will reduce FGC. Other approaches have experimented with alternative initiation rituals (“rituals without cutting,” “symbolic” cutting) and pledge societies. These approaches have produced varying levels of success and failure.

In reality, FGC elimination efforts often combine approaches. Activists and scholars are realizing that change must come from within the community practicing FGC, and that strategies must consider specific cultural and historical contexts. While FGC has become a global issue, spanning local, national, and international arenas, no universally agreed upon elimination strategy exists.

Female “Circumcision” in Africa: Culture, Controversy, and Change. Eds. Shell-Duncan and Hernlund. Boulder: Lynne Rienner Publishers, 2000.

AAWORD. "A Statement on Genital Mutilation." Third World-Second Sex. Ed. Miranda Davies. London: Zed Press, 1983. 217-220.

Aug 29, 2008 3:44 AM

Guest :

Thank you Alanna for a very nice overview of a very complicated subject. I do think the work of a particular NGO bears mention given their exceptional results. Tostan's (www.tostan.org) work on female genital cutting in Senegal and other West African countries has resulted in a series of mass public abandonments of the practice by over 3,300 communities. A recent UNICEF study showed that this model is indeed leading people to completely stop the practice at a large scale.

A major guide for Tostan's approach is the work of Dr. Gerry Mackie of the University of California at San Diego, who has shown that the abandonment process of FGC in Senegal is strikingly similar to the movement that ended footbinding in China at the turn of the 20th Century. In Mackie's model, no one person can abandon such socially significant practices. Instead, groups of people must have the chance to demonstrate publicly their intent to abandon them, otherwise the risk is just too great that their daughters will be seen as unmarriageable and/or outcasts.

UNICEF has done some important work pushing this further, and in fact has now developed a strategy to leverage the work of Tostan and other successful NGOs to bring about a rapid end to the practice.

In the light of the cultural relativism issues you raise above, what is perhaps most significant about Tostan's model is that it is a great example of a hidden middle path, one in which communities, through a long-term, collaborative process facilitated by trained local teachers, use discussions around human rights, democracy, health, and other subjects to make their own decisions about the future of their lives.

Ironically, FGC is just one of literally hundreds of sessions in Tostan's three-year program, and in fact the very first abandonments of FGC were brought about by participants, to the surprise of Tostan's leadership (who initially sought to distance themselves from such a controversial subject).

It is no accident that one of the few programs to have success in this area is also one that doesn't target FGC; one that never uses shocking images or prescriptive messages; one that works on malaria, HIV/AIDS, literacy, microcredit, and many other subjects; and one that approaches communities respectfully and trusts them to make decisions on their own when given good information.

I think we have much to learn from this example--notably that abandonment IS possible while still respecting culture and community autonomy.