The dilemma of FGM Terminology and Typology.

The dilemma of FGM Terminology and Typology. The Dilemma of FGM FGMabbr.female genital mutilation Terminology and Typology. Abdel Magied, Ahmed(School of Health Sciences, Ahfad University for Women Ahfad University for Women is a private women's university in Omdurman, Sudan,and was originaly founded as a girls school by babiker badri in 1905 and was awarded the status of university in 1966. ) WHO (1996) suggested the following typology to be adopted as aunified worldwide classification of FGM: Type I: Excision of the prepuce prepuce/pre��puce/ (pre��pus)1. a covering fold of skin.2. p. of penis.prepu��tialprepuce of clitoris with or without excision of part orthe entire clitoris clitoris/clit��o��ris/ (klit��ah-ris) the small, elongated, erectile body in the female, situated at the anterior angle of the rima pudendi and homologous with the penis in the male. clit��o��risn. . Type II: Excision of the clitoris with partial excision of thelabia minor. Type III: Excision of part or all of the external genitalia andstitching/narrowing the vaginal opening (infibulation) Type IV: Unclassified, includes piercing or incising of theclitoris and/or labia minor; scraping of tissues around the vaginalorifice and/or cutting of vagina, with the aim of tightening it, anyother procedure which falls under the definition of the FGM given. This classification (WHO, 1996) and the suggested typology seemnonspecific, ambiguous and confusing when trying to fit in the types andforms of FGM practiced in Sudan. To begin with and for argument sake, let us agree that FGM includesany intended permanent damage to part/parts or all the external femalegenitalia, with particular emphasis on the girl child for nontherapeutic purposes. In the Sudan, FGM is inflicted on the victimized girl child withouther mature consent at an age normally between 5 and 9, and rarely at 10.At this age the development of the prepuce (hood) of the clitoris isonly vestigial ves��tig��i��aladj.Occurring or persisting as a rudimentary or degenerate structure. , and removing it would need a dexterous dex��ter��ous? also dex��trousadj.1. Skillful in the use of the hands.2. Having mental skill or adroitness.3. Done with dexterity. surgeon and withsophisticated surgical equipment. Accordingly, clitoriectomies which arenormally done by TBAs and midwives in the Sudan would involve at leastexcision of the glans clitoris and the vestigial prepuce. Consequently,recent forms of clitoridectomies practiced in the Sudan might fit in WHO(1996) Type I FGM. However, one alternative of Al Maakouf ([TEXT NOTREPRODUCIBLE IN ASCII ASCIIor American Standard Code for Information Interchange,a set of codes used to represent letters, numbers, a few symbols, and control characters. Originally designed for teletype operations, it has found wide application in computers. ]) form which does not involve excision, butlongitudinal splitting of the whole clitoris (Abdel Magied et al,2003c), neither fits in Type I nor in Type IV. Type II is not practicedin the Sudan; hence none of the Types and forms of FGM practical inSudan would fit in WHO (1996) Type II. On the other hand the claimedPharaonic ([TEXT NOT REPRODUCIBLE IN ASCII]) and intermediate ([TEXT NOTREPRODUCIBLE IN ASCII]) FGM practiced in Sudan, with all their forms,very well fit in Type III (infibulation). On the other hand, permanentdamages inflicted on different parts of the genitalia, mentioned underType IV, are not practiced in the Sudan. Moreover, introduction ofsubstances or herbs to tighten the vagina are only temporary cosmeticapplications by adult women on themselves; hence should not beconsidered under FGM. Consequently, the following classification oftypology is suggested: Type I (Clitoridectomy clitoridectomy/clit��o��ri��dec��to��my/ (klit?ah-ri-dek��tah-me) excision of the clitoris. clit��o��ri��dec��to��myn.Excision of the clitoris. \[TEXT NOT REPRODUCIBLE IN ASCII]): Thisincludes all degrees of excision or damage inflicted on the clitoris.The nature of excision or damage of the clitoris to be given the localname as "form" of clitoridectomy. Type II (Infibulation\[TEXT NOT REPRODUCIBLE IN ASCII]): Thisincludes all degrees of excision of the genitalia beyond clitoridectomyto include other part/parts of the external genitalia, followed bysuturing or not. The nature of the degree of damage of the genitalia tobe given the local name as a "form" of infibulation. Type III (Re-infibulation or Re-circumcision \[TEXT NOTREPRODUCIBLE IN ASCII]): This includes decircumcision andre-circumcision of an already infibulated woman and suturing as inoriginal infibulation. Type IV (Unclassified): This includes all degrees of damage ofpart/parts of the genitalia that do not fall under Types I, II and III.The nature of and the degree of damage on the genitalia to be given thelocal name as a "form" of unclassified FGM (Abdel Magied,2008-b). The validity of WHO (1996) typology had also been challenged byAbdel Magied (1998) and recently by Al Musharaf et al (2006). Mutilation MutilationSee also Brutality, Cruelty.Mutiny (See REBELLION.)Absyrtushacked to death; body pieces strewn about. [Gk. Myth.: Walsh Classical, 3]Agatha, St.had breasts cut off. [Christian Hagiog. and FGM: The term "Female Genital Mutilation \[TEXT NOT REPRODUCIBLE INASCII]" (FGM) would be most appropriate to describe the state of acircumcised female irrespective of the degree of excision of thegenitalia. The term "Female Circumcision [TEXT NOT REPRODUCIBLE INASCII]" may also be used when necessary. Sunna circumcision: The term "Sunna" implies linking with Islamic religion.Therefore, the habitual use of the term "Sunna" when used inconnection with FGM, especially in Muslim countries, implies recognitionand perpetuation of the type as an Islamic practice. Therefore, the term"Sunna circumcision [TEXT NOT REPRODUCIBLE IN ASCII]" shouldbe abolished from the future FGM literature, except when rectifying asituation. The suggested alternative term is "ClitoridectomicCircumcision" or synonymously "Clitoridectomy" ([TEXT NOTREPRODUCIBLE IN ASCII]). This would also be consistent with the typologywhich has been suggested earlier, Infibulation Versus Pharaonic Circumcision: Since the origin of the practice is still controversial and toavoid unnecessary confusion, the term "Pharaonic Circumcision\[TEXT NOT REPRODUCIBLE IN ASCII]" should be abolished from futureFGM literature. The alternative relevant term would be"Infibulation/[TEXT NOT REPRODUCIBLE IN ASCII]", being alsoconsistent with the typology that has previously been suggested by theauthor. Abolition versus Eradication: The word "eradication\[TEXT NOT REPRODUCIBLE IN ASCII]"(extermination exterminationmass killing of animals or other pests. Implies complete destruction of the species or other group. ) implies a forceful physical act, while the wordabolition deals with a holistic concept. Abolition on its own has alwaysbeen used in connection with abolishment of slavery. Doubtless, FGM is atype of slavery specific to the female gender. It is, therefore,suggested that the term "Eradication" becomes excluded fromfuture FGM literature and be replaced by the term "Abolition\ [TEXTNOT REPRODUCIBLE IN ASCII]". Consequently, the following suggestedterminology would become relevant: Abolition of FGM ([TEXT NOTREPRODUCIBLE IN ASCII]) instead of Eradication of FGM ([TEXT NOTREPRODUCIBLE IN ASCII]). FGM Abolition Campaigns([TEXT NOT REPRODUCIBLE IN ASCII]) insteadof FGM Eradication Campaigns ([TEXT NOT REPRODUCIBLE IN ASCII]). FGM Abolitionists ([TEXT NOT REPRODUCIBLE IN ASCII]) to be adoptedsynonymously for Anti-FGM Campaigners and their supporters (AbdelMagied, 1998). State of Circumcision ([TEXT NOT REPRODUCIBLE IN ASCII]): When describing a female's status of circumcision, the term"Uncircumcised uncircumcisedUrology Referring to a ♂ or penis which has not been circumcised. See Circumcision. " should be one of three alternatives: Uncircumcised ([TEXT NOT REPRODUCIBLE IN ASCII]). Clitoridectomised ([TEXT NOT REPRODUCIBLE IN ASCII]). Infibulated ([TEXT NOT REPRODUCIBLE IN ASCII]). Classifying the uncircumcised as one of the states of circumcisionof a female, serves establishing a purposive definition. First, it willserve the purpose of recognition of her circumcision situation as theideal state of circumcision of a female, worth of defending, protectionand campaigning for. Second, it will help lifting the negativepsychological stigma, resulting from the societal inferiorating attitudetowards the uncircumcised female (Abdel Magied et al, 1999). Nevertheless, Susan Al Musharaf et al (2006) concluded thatself-reporting of types of FGM by Sudanese women was not reliable,Hence, recommended revision of WHO (1996) typology, but withoutsuggesting alternatives. It is finally worth mentioning that the not yetendorsed WHO (2007) would also not accommodate the types practiced inSudan. List of References: Abdel Magied, Ahmed; Hagir Al Musharaf; Insaf Adam (2003):Midwives, Traditional Birth Attendants (TBAs) and the Perpetuation ofFemale Genital Mutilation (FGM) in the Sudan. The Ahfad Journal Vol.20,No.2. Abdel Magied, Ahmed and Muna Omran (1999): The Uncircumcised Femaleis an Ideal State of Circumcision. The Ahfad Journal, Vol. 16, No.2. Abdel Magied, Ahmed (2008): Female Genital Mutilation in Sudan--aHuman Rights Issue--(Unpublished book). Abdel Magied, Ahmed (1998): Some FGM Terminology between theNegative and Positive Impacts. The Ahfad Journal, Vol. 15, No.(2). Susan Al Musharaf; Nagla El Hadi; Lars Almorth(2006): Reliabilityof Self Reported Form of Female Gemital Mutilation and WHOClassification: Cross SectionalStudy.BMJ,DOI:10.1136/bmj.38873.649074.55. UNICEF, WHO, UNFPA UNFPA United Nations Population Fund (formerly United Nations Fund for Population Activities)UNFPA United Nations Fund for Population Activities (now United Nations Population Fund)(1996): Statement, Female Genital Mutilation.Geneva Geneva, canton and city, SwitzerlandGeneva(jənē`və), Fr. Genève, canton (1990 pop. 373,019), 109 sq mi (282 sq km), SW Switzerland, surrounding the southwest tip of the Lake of Geneva. , WHO. WHO (2007): WHO Typology Modified 2007 (not yet endorsed).