Female Genital Mutilation And Surgical Reconstruction.

Female Genital Mutilation (FGM) is a practice that is carried out in Africa and some other parts of the world. It is the partial or total removal of the external female genitalia (Clitoris), which is responsible and heavily tied to female sexuality because it enhances female sexual arousal and function. FGM is a cultural belief that aims to maintain sexual purity in the female gender with no health benefits attached to it. Female genital mutilation is also referred to as cutting, pricking, or female circumcision. The World Health Organization has classified into four types ranging from partial clitoral resection to complete excision along with the majority of the vulva. The victims of FGM are subjected to a list of short and long-term complications such as injury to the patient’s sexuality and feminine identity, which could be extensive and morbid. Reconstructive surgery is a necessary addition to psychotherapy to provide restoration of form and function to women who have been victimized by Female Genital Mutilation. The goal is to correct the appearance of the vulva to achieve proper clitoral function and a healthy vulva appearance.

Historical Background of Female Genital Mutilation

The exact origin of Female circumcision is unknown. However, it has been discovered that the signs of female circumcision mark ancient Egyptian mummies of the daughters of priests and rulers as a sign of elevated social status.  Female genital mutilation is practiced in most African countries by Christians, Muslims, and Jews in states where it is culturally acceptable. However, it is predominantly practiced in the sub-Saharan region of Africa. In some cultures, FGM is considered as a necessary rite of passage that purifies a girl child by removing her unclean clitoris and labia. This motivating factor has contributed to the perpetuation of female genital mutilation as a standard practice that is rooted in ancient tradition. The majority of girls undergo FGM at age 15, while in some cultures, it is performed on the girl child during infancy, although it can be performed at any age.

The primary reason for this practice is he believes that it would reduce or eliminate sexual arousal and pleasure in a female. It is to reduce the risk of her engaging in sexual intercourse outside or before marriage, thereby maintaining purity. Another reason for this practice can also be viewed from the cultural context where mother generally wants to raise daughters who are modest and socially desirable in every generation. FGM is a procedure carried out by nonmedical providers like midwives or local women who are considered by experts in carrying out this procedure. However, they perform without sterile surgical instruments, or any anesthesia thereby exposing the victims to complications and chronic infections such as

  • Hemorrhage
  • The transmission of HIV or hepatitis
  • Dyspareunia
  • Urinary tract infections (UTIs)
  • Death
  • Psychological disturbance
  • High risk of pregnancies.

World Health Organization Female Genital Mutilation Report

Table 1.

WHO Female Genital Mutilation Classifications

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Schematic representation of The WHO’s FGM classification system types 1–3.

Most Vulvar reconstruction work on FGM victims is being carried out by Urologists and Obstetrician-gynecologists. However, plastic and reconstructive surgeons are traditionally at the forefront of innovating renovative therapies and techniques.

Conclusion

The conditions under which Female Genital Mutilation occurs are always inhumane. It can be described as the violation of human rights, as many victims do not know nor understand what is being done to them. Since most were circumcised before the age of seven. However, there is a growing global outcry at the practice. People are being educated on its effects, through campaigns and conferences as initiatives to reduce and eventually eliminate FGM. Because every girl deserves to feel the pleasure of sexual intercourse and be proud of her sexuality.

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