Female genital mutilation still prevalent in 94 countries including India, finds study – eShe

A new Equality Now report has found that at least 230 million people across the world in 94 countries have undergone female genital mutilation (FGM) despite activism and education against this harmful practice. Of these, 80 million girls and women have been identified in Asia.

FGM involves the partial or complete removal of external female genitalia for non-medical reasons. There are many terms used to describe this practice, including female circumcision, female genital cutting, khatna (in South Asia), sunat, sunat perempuan, and others. Though FGM is most prevalent in parts of Africa, it has been reported in 94 countries including India.

The cruel practice is essentially an attempt to control women’s and girls’ bodies and sexuality. An outcome of misogyny and gender inequality, it is believed to help avert pre-marital sex, prevent wives from being unfaithful, and reduce uncertainty relating to paternity. It is also projected as a prerequisite for marriage: men may refuse to marry a girl or woman who has not undergone FGM.

But, for the victims, there are severe short- and long-term effects, including chronic pain and infections, psychological trauma, infertility, and higher rates of maternal and infant mortality.

Dr. A. Renee Bergstrom, an 80-year-old great-grandmother who grew up in South Dakota, USA, shares: “When I was three years old, a doctor cut my body. My mother had taken me to the clinic after noticing I was touching my genital area while playing. Concerned, she sought advice from a doctor who was a member of the Seventh-day Adventist church. At the time, their teachings were strict about masturbation, viewing it as sinful. The doctor told my mother, ‘I can fix that,’ and performed what I now know was FGM, removing my outer clitoris.”

She remembers the pain, lying on the table, seeing her mother at the foot of it and feeling betrayed. When they got home, her mother told her, “Never talk about this.” For years, Dr Bergstrom didn’t share her story, facing pain and complications during childbirth, until she finally understood what had happened to her, and became an activist raising awareness about FGM.  

There are between 421,000 to 577,000 women and girls living in the United States who have either undergone FGM/C or are at risk, the Equality Now report says.

FGM is considered a serious human-rights violation, and has been included as a target within the United Nations Sustainable Development Goals. Despite this, only 59 of the 94 countries where FGM has been found have laws explicitly prohibiting FGM.

Governments have shown reluctance to act in the face of deeply ingrained traditional customs. For some communities, FGM is seen as an integral part of their cultural identity.

The lack of legal frameworks is further compounded by insufficient data, low awareness, and a lack of funding and decisive action from the international community. This leaves many millions without adequate protection and enables perpetrators to avoid accountability. 

In India, FGM is practised by the Bohra community, estimated to be around 1 million people. It is also practised by some Sunni Muslim communities in Kerala. The Bohra community practises Type I FGM (cutting of the clitoral hood and/or the clitoris), known locally as khatna or khafz. There is no specific law in India against it.

A 2018 study of FGM within the Bohra community (with participants across five Indian states: Gujarat, Madhya Pradesh, Maharashtra, Rajasthan, and Kerala) found that 75 percent of daughters of all respondents in the sample had been subjected to khatna.

Another 2017 study surveyed 385 participants from the Bohra community across the world. Out of these, 217 of the participants reported that they had undergone FGM in India. A 2021 study by Mumkin, which included 221 respondents from the Bohra community, of which 159 were from India, found that 81 percent of respondents opposed the practice of FGM. A 2022 survey conducted in New Delhi found low awareness of the existence of FGM amongst the public.

Founder and India Lead of the activist organisation WeSpeakOut, Masooma – who is also an FGM survivor – says, “I think it is important that the narrative on FGM moves towards Asia, there has to be recognition that it is an international problem. We have to focus on the newer realities, the forms in which it is done, and the ages when it is done. There are big and small pockets of FGM happening across Asia… If you are talking about the complete elimination of FGM, every woman and girl counts.”

The new report, ‘The Time Is Now: End Female Genital Mutilation/Cutting’, is an update to an earlier 2020 report on FGM around the world. “Mounting evidence clearly shows that FGM/C is a worldwide issue demanding a coordinated global response,” says Equality Now’s Divya Srinivasan.

The problem is compounded by some governments failing to recognise FGM in their countries, and in some cases actively denying it, undermining and sometimes openly discrediting the work of survivors and activists.

Growing medicalisation of FGM is another concern. UNICEF’s 2024 report found 66 percent of girls who recently underwent FGM did so at the hands of a healthcare worker. In countries like Egypt, Indonesia, and Kenya, medicalised FGM is wrongly perceived by some as a legitimate alternative, while in Russia, it is openly advertised by clinics.

Dena, a 27-year-old Indonesian-American writer, poet and playwright based in New York, was nine years old when she underwent female genital cutting (FGC) on a family visit to Indonesia – her first trip to her native country. Her aunt took her on a long journey away from their family home.

“There was a metal table and medical supplies, but it wasn’t a hospital. My aunt pushed me onto the table, held me down, and instructed me to keep my legs open. I was scared, confused and crying but felt compelled to obey. The woman performing the procedure used a scalpel. I vividly remember the coldness of the blade and the sharp sensation of being cut. The pain was immediate and overwhelming, and the feeling of gauze being pressed into the wound was agonising. When it was over, I couldn’t walk properly for days.”

At the time, Dena did not fully understand what had happened to her. Her family explained it as sunat perempuan, a cultural practice rooted in the belief that cutting a girl’s genitalia reduces her sexual desires and ensures her purity.

“For my aunt, this was a preventative measure to protect me from premarital sex, abuse, or being perceived as promiscuous, issues she believed were especially prevalent in the United States where I was being raised,” she shares. It was not until years later that she realised the full extent of what she had undergone and its implications.

There are also similar practices not yet formally recognised as forms of mutilation. This includes the ‘husband stitch’, when an extra stitch is added during vaginal repair after childbirth, with the purpose of tightening the vaginal opening to increase sexual pleasure for a male partner. Often performed by medical professionals without the woman’s consent, recent research has found cases in Europe, Japan and the United States, with survivors experiencing health complications and comparing it to FGM. 

The newly released report, ‘The Time is Now‘, is the result of a collaboration between the nonprofits Equality Now, End FGM European Network, and US End FGM/C Network.  

Illustrations courtesy: Equality Now