The horrific practice of female genital mutilation (FGM), to which young girls between infancy and adolescence in particular are still subjected, continues to be performed in different regions of the world—more precisely, in at least 92 countries located mainly in the Middle East, Africa, and Asia. In total, more than 200 million girls and women today have undergone some form of FGM, and approximately three million girls risk being subjected to it each year.

The practice of FGM represents a serious violation of human rights, and is a cruel form of violence which discriminately targets girls and women. FGM violates children’s fundamental rights when performed on minors, and breaches the rights of both women and girls to health, security, physical integrity, freedom from torture or cruel, inhuman or degrading treatment, and the right to life, if the injury results in the victim’s death. A person’s right to the highest attainable standard of health is also violated, as this practice disrupts healthy genital tissue without a medical reason.

The Middle East and North Africa (MENA) region constitutes a geographical area where FGM is particularly practised, along with other parts of Africa and Asia. About a quarter of the 200 million girls and women who have undergone FGM worldwide come from five countries in the MENA region, namely Egypt, Sudan, Yemen, Iraq, and Djibouti. FGM is also performed in other countries in the region, where specific communities perform it and for which little information is available to outsiders.

Understanding the causes and consequences of FGM

A major gender-based discrimination, FGM entails partial or total removal of the external female genitalia or other injuries to the female genital organs, carried out in the absence of medical reasons. This practice is mainly performed on girls and women living in rural areas, in less wealthy families, and with low levels of formal education. Moreover, it is mainly children and adolescents who are subjected to the act, which causes extreme physical pain, deep psychological trauma, and serious health hazards. The practice of FGM is increasingly performed by local medical professionals, which makes this grim procedure less painful. Traditionally, however, FGM is carried out under non-sterile conditions by an older woman in the community—a relative or birth attendant who is not an expert in female anatomy—and without the use of anesthetics, analgesics, and antibiotics.

The different forms of FGM pose serious threats to the health of the victims, all of whom experience severe pain, bleeding, and trauma. In the short term, FGM causes shock, hemorrhage, and a risk of infection. These problems may lead to disability, urination problems, infertility, miscarriage, stillbirth, increased risk of infant death, and the eventual death of survivors from complications. In the long term, victims develop chronic pain and lingering infections as well as mental health issues, including post-traumatic stress disorder.

Although FGM causes serious damage to the physical and mental health of girls and women, it is still carried out in many countries. In certain communities, FGM constitutes a religious requirement, even though no major religious text calls for it. In many societies, the practice of FGM continues to be carried out due to cultural beliefs that consider it indispensable for the preservation of ethnic and gender identity, femininity or female “purity”, and family honour, as well as for the promotion of cleanliness and health and to ensure women’s marriageability. Social acceptability, the guarantee of fidelity after marriage, and the prevention of rape represent other main reasons for the justification of FGM. Finally, there are also non-cultural reasons for performing the act, namely, to promote male potency, decrease childbirth deaths, and reduce a woman’s libido, i.e. make her more attractive to her future husband.

Of the approximately 200 million girls and women who have undergone FGM today, some 31 million live in Egypt, while 2 million reside in Yemen. In Egypt, the percentage of girls and women between 15 and 49 years old who have undergone FGM is 87%, while the percentage of girls under the age of 15 who have undergone the procedure is 14%. Approximately eight out of 10 Egyptian girls are subjected to FGM by medical personnel, which demonstrates the high level of medicalisation of the procedure in the country. FGM in Egypt is performed about seven times out of 10 on girls between 10 and 14 years old; otherwise, it is practised on females between the ages of five and nine. Despite a decrease in support for FGM over the years, more than half of Egyptian girls and women are still of the opinion that the practice should continue, which is similar to the percentage of the country’s men who support it. FGM in Egypt is rooted in tradition, and has been practised for thousands of years in order to maintain the so-called purity and cleanliness of girls, as the removal of the clitoris is considered as a way to avoid female sexual arousal and virginity loss before marriage. Also considered a religious requirement, FGM is accepted by many girls and women who fear marginalisation or outright rejection, although the practice has been a penal crime since 2008. However, perpetrator doctors practising FGM hide behind the excuse of medical reasons to bypass the law.

In Yemen, the percentage of girls and women between 15 and 49 years old who have undergone FGM is much lower at 19%, while the percentage of married girls and women aged between 15 and 49 whose daughters have experienced FGM is 16%. FGM in Yemen is performed by traditional practitioners in more than eight out of 10 cases, and the country has a level of medicalisation of just over 10%. In 87% of cases, FGM is performed on Yemeni newborns during their first week of life, and in 9% of cases, performed within their first year of life. Over the years, support for FGM by girls and women in Yemen aged between 15 and 49 has declined sharply, falling below 20% in 2013. Similar to motivations in Egypt, FGM is practised in Yemen in order to preserve the so-called cleanliness, beauty, and femininity of girls, and about 21% of women there believe it is a religious duty. Finally, Yemen’s ban of FGM in medical facilities has led to FGM performers—primarily female family members—to practise it in homes using razor blades or scissors, without the possibility of receiving medical assistance.

Use of the international legal framework to protect girls and women against FGM

Rooted deeply in gender inequality, the brutal practice of FGM causes serious physical and mental health issues, and violates the human rights of all girls and women who undergo it. Girls and women worldwide have the right to be protected and preserved from this discriminatory, violent, and intensely harmful procedure, which absolutely must be stopped. Several human rights instruments at the international level offer protection to girls and women against different forms of gender-based discrimination and violence, which includes the practice of FGM.

The 1948 Universal Declaration of Human Rights defends girls and women, although implicitly, against the practice of FGM, as it promotes the right to life, liberty, and security (Article 3), and the right to be free from torture or cruel, inhuman, or degrading treatment or punishment (Article 5). Gender-based discrimination, which FGM falls under, is also denounced in the 1966 International Covenant on Civil and Political Rights (ICCPR), which promotes the right to be free from torture or cruel, inhuman, or degrading treatment (Article 7), as well as promotes the right to liberty and security (Article 9), and upholds the right to measures of protection for all children (Article 24). In addition, the 1976 International Covenant on Economic, Social and Cultural Rights states that women and men have the same right to the enjoyment of economic, social, and cultural rights (Article 3), and that all individuals must be entitled to the highest attainable standard of physical and mental health (Article 12)—which should guarantee the abolition of harmful practices such as FGM.

The 1979 Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW) defines gender-based discrimination, which applies to the FGM procedure—though it is not explicitly mentioned—because FGM is carried out on girls and women specifically, violating their fundamental rights. The general recommendations No. 14, 19, and 24 from the Committee on the Elimination of Discrimination against Women underline the serious damages to the health of girls and women who have undergone FGM, which is considered a form of violence against females, and encourage States Parties to work towards eliminating it. Moreover, the Committee of the 1989 Convention on the Rights of the Child (CRC) condemns the traditional practice of FGM, as it violates the best interests of children.

In the UN General Assembly Declaration on the Elimination of Violence Against Women of 1993, FGM is explicitly recognised for the first time as a form of violence against women (Article 2), defined in part as “any act of gender-based violence that results in, or is likely to result in, physical, sexual or psychological harm or suffering to women, including threats of such acts, coercion or arbitrary deprivation of liberty” (Article 1). Subsequent resolutions and reports of the UN General Assembly encouraged States to fight against the practice of FGM; Resolution 61/143 of 2007 called on States not to hide behind religious or cultural beliefs to defend the practice. In 2012, the unanimous UN General Assembly Resolution 67/146 was passed, emphasising the urgency of condemning FGM, implementing legislation at the national level to eliminate the procedure, and raising awareness about the issue.

More recently, the UN Sustainable Development Goal (SDG) 5, dedicated to the promotion of gender equality and the empowerment of women and girls, included target 5.3 in an aim to end harmful practices including FGM specifically by the year 2030. Finally, Resolution 44/16 on the elimination of FGM was adopted by the Human Rights Council in 2020, in order to intensify the fight to eradicate the practice globally and achieve zero tolerance by 2030.

Although the Middle East and North Africa region has made progress in reducing the harmful practice of FGM undergone by girls and women aged between 15 and 49 in the last generation, the procedure still remains far too prevalent in the region. The only way to achieve target 5.3—which aims to eliminate harmful practices against girls and women, including FGM, by 2030—is to increase the rate of progress by 15 times in the MENA region.

The United Nations Children’s Fund (UNICEF) and the United Nations Population Fund (UNFPA) are currently working together as the Global Programme to End Female Genital Mutilation in the battle against FGM. The programme aims to support countries in the MENA region by collaborating with governments, regional political entities, civil societies, and communities to increase accountability and promote the implementation of laws and policies combating FGM. It also envisages empowering girls and women to enjoy their fundamental rights by working with their parents and communities to change cultural and social norms promoting the practice. Additionally, the programme strives to ensure girls’ and women’s access to appropriate, quality services for prevention, protection and care, representing another aspect of its strategy. Finally, it supports countries in analysing data to monitor and evaluate interventions focused on abolishing FGM, to assess cultural change over time, and to adjust and improve implemented policies as needed.