Marcy Bloom does U.S. advocacy and capacity building for GIRE—El Grupo de Informacion en Reproduccion Elegida/The Information Group on Reproductive Choice.

Female genital mutilation (FGM), also called female genital cutting (FGC), refers to the cutting, removal, and sometimes sewing of part or all of the external female genital tissue (the labia, clitoris, or both) for cultural or other non-therapeutic reasons. This traditional practice affects an estimated 130 million girls and women worldwide, mainly in 28 African countries, but also in Asia, the Middle East, Europe, Australia, and the United States. It is estimated that every year 2 million more girls (that is 6,000 girls every day) are at risk from the practice. One out of three girls or women die as a result of the most extreme type of FGM/C that is classified by the World Health Organization as Type III. This is where the external genitalia are partially or completely removed and the vaginal orifice is stitched together, leaving only a small opening for urination and menstruation.

FGM/C violates international standards for the human rights of girls and women and often leads to serious psychological and physical health problems for girls as young as one year. These include pain, shock, trauma, tetanus, hemorrhage, and septicemia at the time of the procedure, which is usually performed in unsanitary conditions. Long-term complications include recurrent urinary tract infections, painful sex, genital malformation, painful menstruation, delayed menarche, chronic pelvic pain, and ongoing pelvic infections.

Tragically, women have been unnecessarily "cut" for thousands of years. The serious physical, psychosexual, and social implications of the practice are far too frequently cast aside in favor of numerous socio-cultural, religious, and aesthetic or hygienic justifications. Almost all of these are linked to girls' rite of passage to womanhood, social status, marriageability, worth to the community, and future fertility (PDF). Yet the ritual continues to be justified in many communities in the developing world by a wide variety of cultural norms and traditional beliefs.

One of these traditional justifications is the belief that the procedure helps to ensure family honor, cleanliness, virginity, and a wife's fidelity by preventing sexual desire in girls and women. A girl who is "uncut" may be considered "unclean" (as the clitoris is considered to be "dirty") and, therefore, stigmatized as unmarriageable.

How can we reverse this long-standing and highly ritualized oppression towards women? Human and women's rights activists believe that sharp condemnation by religious and moral leaders is one of the core actions needed to ban this horrific practice. In December, "a minor revolution took place" in this direction in Cairo, Egypt at a conference with the long but ultimately effective title "The Prohibition of Violation of the Female Body through Circumcision." The conference was sponsored by Target Human Rights, whose founder, Rudiger Nehberg states, "This custom can only be brought to an end with the power of Islam." Muslim academics, scholars, and theologians from Germany, Africa, and the Middle East agreed that the practice of FGM/C is irreconcilable with Islam and, in fact, that the Quran states that it is forbidden to mutilate God's creation. This significant outcome looms large in the fight to stop FGM/C.

Equally as important, every doctor at the conference agreed that there is no medical justification for FGM/C. Yet, in Egypt, 75% of FGM/C procedures are performed by doctors and this medicalization of the procedure—"willful damage to healthy organs for non-therapeutic reasons"—has made it seem more acceptable The World Health Organization, as well as the International Council of Nurses, the International Confederation of Midwives, and the Federation of Gynecologists and Obstetricians, have declared their opposition to the medicalization of FGM/C, and have advised that it not be performed by health professionals under any circumstances. The conference doctors' unity on this perspective was yet another ground-breaking outcome.

Six months prior to the December conference, the June 3, 2006 edition of The Lancet, a prestigious British medical journal, reported on the relationship between FGM/C and obstetric outcomes at 28 obstetric centers in six African countries. The study occurred in countries where FGM/C is a common practice; more than 28,000 women participated in the study.

The results show that deliveries to women who have undergone FGM/C are significantly more likely to be complicated by caesarean section, post-partum hemorrhage, episiotomy, extended maternal hospital stay, resuscitation of the infant and inpatient perinatal death, than deliveries to women who have not had FGM/C… Adverse obstetric and prenatal outcomes can therefore be added to the known harmful and long-term effects of FGM/C. (Volume 367, June 3, 2006: "Female Genital Mutilation and Obstetric Outcome: WHO Collaborative Prospective Study in Six African Countries").

With this new medical information about FGM/C's negative effects on the health of women and babies, and the revolutionary outcome of the Cairo conference, there is renewed hope that the ritual and practice of FGM/C will continue to be questioned. The international community must continue to speak out on behalf of girls and women and demand that governments criminalize the practice, launch educational programs to combat the procedure, and offer communities alternative rites of passage and standards of marriageability for their daughters. As we have seen, it is critical for religious leaders and physicians to be integrally involved with this work.

Those who may hesitate to criticize FGM/C out of misplaced reverence for other cultures should heed the words of Bogaletch Gebre, the executive director of the Kembatta (Ethiopia) Women's Self-Help Center, who was cut at the age of six.

When culture affects one's human integrity, when it violates it—be it in terms of gender or in terms of ethnic group—that culture should be condemned, because whenever one of us is hurt or violated, all of us are violated. Until we restore the health of women, until we empower and educate women, until we stop the maiming, mutilation, and disregard of women's bodies, we cannot turn back the historic maiming of our culture or the modern maiming of our countryside.

Eloquent words. This is, after all, about women's rights and status in society. FGM/C is a shocking symptom of what occurs when those fundamental human and civil rights—our basic worth as human beings—are denied to women. That is the real struggle ahead.