Female Genital Cutting: An Ancient Practice Embedded in an Ever-Evolving World

Abstract

Female genital cutting (FGC), formerly known as female genital mutilation or circumcision, is a ritual that involves the partial or total removal of the external genitalia. Four categories of FGC have been described based on how much of the genitalia is removed. FGC has been associated with a myriad of health complications such as life-threatening bleeding during the cutting, chronic infection of the uterus and vagina, dysmenorrhea, and sterility. It is also likely to promote transmission of disease such as HIV/AIDS, hepatitis, and urinary tract infections secondary to nonsterile equipment. Surgical correction of the external genitalia can be offered to these women in order to prevent depression, severe dysmenorrhea, infertility, frequent urinary tract infections, or retention cysts and abscesses that can progress to sepsis and death. Surgical correction also promotes women's health by allowing for routine PAP smears, hysteroscopies, transvaginal ultrasounds, and insertion of urinary catheters. FGC is practiced as a cultural ritual by ethnic groups in numerous countries in the Sub-Saharan and Northeast African regions and to a lesser extent in Asia, the Middle East, and within immigrant communities elsewhere. This case report discusses a Somalian woman who presents for reconstruction of her external genitalia following an experience with genital cutting in her native country. It is written in an effort to promote awareness and establish collaborations and exchange of expertise among medical personnel. This understanding will better enable the health care community to help these women restore their health, femininity, and empowerment.