Female Genital Surgery Research Articles

Feature: Issues on female genital mutilation/cutting—progress and parallels

Kelly Morris is a freelance writer/ researcher, with particular interests in sexual health, environmental issues and medicine, and neurosciences. In her spare time, she loves music and dancing, cookery, and walking in the countryside, where she forages for wild food.

Female Genital Cutting

The practice of female genital cutting is known by various names, such as female circumcision, female genital mutilation, or female genital surgeries. This article examines cutting and looks at the historical background, types of cuttings, prevalence, and why the practice continues. Nurse practitioners may encounter patients who have had this type of procedure.

Treatment of experimental ureteral strictures by endourological ureterotomy and implantation of stents in the porcine animal model

The objective of this study is to evaluate the dilation of the ureter using endoureterotomy and an expanding-sheath double pigtail ureteral stent in the treatment of experimentally induced ureteral strictures in the porcine animal model. This is a new treatment in the ureteral strictures resolution in Veterinary Urology, although it is not a common affection, it usually appears as a consequence of ureteritis and in the iatrogenic female genital surgery. The experimental study is design in three phases: induction of experimental stricture, diagnosis and treatment of the stricture and follow-up. We have used 10 healthy Large White female pigs. The internal ureteral diameter was measured prior to laparoscopic ligature stricture induction using retrograde ureteropyelography (RUPG). Experimental stricture was diagnosed 4 weeks after intervention, using RUPG and ultrasound, and treated by endoureterotomy and subsequent placement of a double pigtail ureteral stent, which was removed 6 weeks later. The study finished 4 weeks later with measurement of ureteral diameters using RPUG and ultrasound evaluation. Except in one case, all ureters displayed permanent dilation of the strictured area for 10 weeks after treatment (6 weeks with ureteral stent and 4 more weeks without stent). Finally, this technique proved to be effective in cases of short-length and short-living ureteral strictures, and represents a viable alternative to conventional surgery in animals.

Female genital mutilation and human rights

This article evaluates five different discourses on female genital mutilation for affinities with the language of international instruments codifying human rights: an activist physician's fieldwork journal; two novels, one a Lebanese-American's lyrical work largely indebted to a human rights perspective and, in contrast, a Kenyan publicist's fiction which mutes that approach; an American activist's auto-ethnography; paintings by Nigerian artists in an exhibition travelling in Germany; and a letter to the editor of an African American magazine. I read these varied lexica in light of recent literature on female genital surgery that tends to oppose academics, mainly anthropologists captive to their training, to activists impatient with post-modern wavering who claim that global instruments for women's human rights should be enforced to stop genital torture. Creative writing is instrumental in presenting a clear moral imperative confronted by the complexities of human lives.

Cultural Suppression of Female Sexuality

Four theories about cultural suppression of female sexuality are evaluated. Data are reviewed on cross-cultural differences in power and sex ratios, reactions to the sexual revolution, direct restraining influences on adolescent and adult female sexuality, double standard patterns of sexual morality, female genital surgery, legal and religious restrictions on sex, prostitution and pornography, and sexual deception. The view that men suppress female sexuality received hardly any support and is flatly contradicted by some findings. Instead, the evidence favors the view that women have worked to stifle each other's sexuality because sex is a limited resource that women use to negotiate with men, and scarcity gives women an advantage.

The politics of female genital surgery in displaced communities

International efforts to control female genital surgery (also referred to as female genital mutilation) have mainly targeted countries where the practice is culturally sanctioned. Women in these countries belong to a mainstream culture and are supported by their communities through the process of debate and change. In displaced communities, particularly among migrants and refugees living in Western countries, women from these communities are the visible minority, and the focus and implementation of legislation and health policy addressing female genital surgery risks creating or increasing inequities in access to reproductive health. This paper reviews health policy on female genital surgery in Australia. We relate the frequency of genital cosmetic surgery in the wider population to procedures such as re-infibulation following childbirth, requested by African women; this latter procedure is illegal and currently unavailable in most public hospitals. Data are presented to highlight the effects of these and other political and legal inconsistencies on the reproductive health of women from displaced communities.

What is Missing? (Female Genital Surgeries - Infibulation, Excision, Clitoridectomy - in Eritrea)

This article investigates female genital surgery in Eritrea (FGS). It places the practice within a broad, multidisciplinary context. After classifying different forms of surgery, I discuss the current situation using a survey and historical anthropological accounts. I then examine the explanations given for the practice and finally analyze the internal legal and political debate surrounding FGS.

Vulvar epithelial inclusion cyst as a late complication of childhood female traditional genital surgery

Epithelial inclusion cysts may be a late complication of traditional female genital surgery. We present the case of a 19-year-old Eritrean woman who had been circumcised at birth and sought treatment for an enlarging vulvar mass that arose after the onset of puberty. Symptoms included pain, pruritus, and interference with walking. (Am J Obstet Gynecol 2000;183:509-10.)

Female genital surgeries: the known, the unknown, and the unknowable.

This article reviews the literature on female genital surgeries and examines the extent to which available research supports commonly accepted "facts" about the prevalence and harmful effects of these practices, in particular their possible health complications, and their effect on sexuality. While information regarding the prevalence of female genital surgeries is becoming increasingly available, the powerful discourse that depicts these practices as inevitably causing death and serious ill health, and as unequivocally destroying sexual pleasure, is not sufficiently supported by the evidence. The article discusses some of the implications of research on female genital surgeries for the societies that are involved--not merely those where the practices are found, but also those whose gaze has been so intensely focused on the customs of others.

On Cutting Women's Genitals

This review of the literature examined the available evidence regarding the effects of what we call ‘female genital surgeries’ on women's health and sexuality. (t shows that the evidence on the consequences of female genital surgeries for health and sexuality is insufficient to support the powerful rhetoric that presents these practices as a grave danger to women's health. However, the scarcity of evidence is most likely due to the lack of concerted efforts to investigate harmful effects, rather than to the relative safety of these operations. There are few studies that can provide estimates of the health risks associated with female genital surgeries. Complications are found to be more frequent for more extensive surgeries; the frequencies of complications are around 1 per cent for serious, and 1–18 per cent for less serious, complications. The findings on sexuality are inconclusive but nonetheless suggest that many women who have had the surgeries have the capacity for sexual enjoyment. This review underscores the need for systematic studies of the health complications of female genital operations, and emphasises the importance of understanding the meaning ofthese practices and the risks associated with them in the societies where they are prevalent, in order to inform discussions of the implications of individual choices and policy decisions. This paper is followed by responses from Seham Abd el Salam, Iocelyn DeJong and Marie Basily Assaad, who each discuss the term ‘female genital surgeries’ as an alternative to ‘female genital mutilation’. They also discuss the subjective and symbolic use ofthese practices as a means of social control of women and women's sexuality, the relationship between research and advocacy work and what sorts of information are needed for each of them; the methodological and ethical constraints in conducting studies on the harmful effects of these practices; the relationship between national and international advocacy work on FGM; and the importance of challenging the culture of silence on this subject and bringing discussion into the open in order to bring about change.

Female "circumcision": African women confront American medicine.

The practice of female “circumcision,” or traditional female genital surgery, is simultaneously complex and controversial. Although some consider it a human rights infringement, others view it as an integral part of cultures in which it remained unchallenged for centuries. With more than 30,000 Africans entering the United States in the last decade, American clinicians are challenged with meeting African women’s health needs, as they are barraged with a debate about the ethics and politics of circumcision. There are significant medical sequelae and public health ramifications of female circumcision; therefore most U.S. physicians probably would agree that programs to abolish it should continue. However, although there is ample media and political attention to this volatile issue, there is a relative dearth of practical, clinical information available to providers who care for circumcised women and their families. As African communities and advocates grapple with how to stop this practice, circumcised women need clinicians familiar with these surgeries, who will move beyond negative feelings they may have about the practice in order to treat women knowledgeably and with dignity. It is important to distinguish respect from unreflective acceptance. However, blanket condemnation by health workers will not help families decide how to break a long-standing tradition by choosing not to circumcise their daughters. On the contrary, by unwittingly conveying revulsion toward circumcised women and children, providers may drive these families away from the health care they need. Our objective is to understand and address the conflicts that occur when clinicians provide care to patients whose beliefs and practices differ from their own. We review the practice, cultural significance and medical complications of female circumcision, and offer sensitive clinical guidelines, illustrated by case examples, for caring for currently circumcised women.

A balanced approach to traditional female genital surgeries

A balanced approach to traditional female genital surgeries

Ritual female genital surgery among Ethiopian Jews.

Ritual female genital surgery is usually associated with Muslim countries although it is normative also among Ethiopian Coptic Christians. Ethiopian Jewish women immigrants to Israel report that ritual female genital surgery was normative in their culture in Ethiopia, but expressed no desire to continue the custom in Israel. This contrasts with Israeli Bedouin Muslims, who were reported to regard ritual female genital surgery as an important part of their identity. Physical examination of 113 Ethiopian Jewish immigrant women in Israel found a variety of lesions in about a third of women, with 27% showing total or partial clitoral amputation. The heterogeneity of the physical findings contrasts with uniform verbal reports in interviews of having undergone a ritual of female genital surgery.

Judging the Other: Responding to Traditional Female Genital Surgeries

Traditional female genital circumcision, or female genital mutilation, performed upon women in some non-Western cultures has provoked considerable international controversy since the late 1970s. Western feminists, physicians, and ethicists condemn such practice. Having made moral judgement against female genital mutilation, however, what is the next step? There is clearly an impasse between cultural relativism on the one hand and universalism on the other. Those at the forefront of the debate on female genital mutilation must learn to work respectfully with, instead of independently of, local resources for cultural self-examination and change. The authors discuss cultural relativism and moral universalism; female circumcision in sections on epidemiology, health effects, and culture, religion, and social change; the debate historically; the response of Arab and African women; and moving beyond the impasse.

Ritual female genital surgery among bedouin in Israel

Ritual female genital operations are common in many parts of the world, with varying degrees of mutilation from clitoridectomy and removal of the labia to removal of the clitoral prepuce. Interviews of 21 Bedouin women in southern Israel revealed the practice to be normative in several tribes. However, physical examination of 37 young women from those tribes at a gynecological clinic revealed only small scars on the labia in each woman. Bedouin in southern Israel may offer a model of evolution of female circumcision into a nonmutilative ritual incision.

FEMALE GENITAL SURGERY AND MENTAL ILLNESS.

FEMALE GENITAL SURGERY AND MENTAL ILLNESS.

CRITICISM AND BIBLIOGRAPHY.

Uterine bleeding: ethiology, diagnostics, treatment, description of the method of investigation of female genital organs, their anatomy and surgery. V. Ѳ. Snegireva, prof. IMPERIAL Moscow University. Second edition, with 205 figures and 8 tables, revised and supplemented. Moscow, 1895 (460 and XXV pages, in a large 8th share of the sheet).