Why is circumcision not considered genital mutilation?

Genital mutilation : "It has nothing to do with religion"

Miss Dr. Tennhardt, in the course of the circumcision debate, not a few mention female and male circumcision in the same breath. As a gynecologist, what do you think of this?

As a gynecologist, I don't know enough about the consequences of the procedure on men. But I would strictly separate them, female circumcision does not belong in the current discussion. Both are rites of initiation and interventions in the physical integrity. But medically it is a completely different matter whether I cut off the penis foreskin or remove the clitoris or labia. It is not for nothing that the World Health Organization speaks of FGM, female genital mutilation, of genital mutilation. Although I strongly oppose describing all these women as sexual cripples.

Why?

Because the consequences are so different and it depends very much in which countries and how radically the women were circumcised. This has to do with sexual practice, of course; Even an intact woman can experience sexuality as very unfulfilling. For example, in a survey of Nigerian women, no major differences were found between uncircumcised and circumcised. Statistically, this happens to 95 percent of women in Sierra Leone. When I worked there, I didn't meet a single uncircumcised woman. But I didn't have the feeling that I was surrounded exclusively by psychological wrecks.

What interventions are there and what are the consequences?

As everywhere, the psychological consequences are very different. Genital mutilation is certainly always a loss of trust, especially since it happens through women, and also through close people. And physically, the female genital has a wonderful ability to heal - this is important for birth injuries, for example - but all these interventions can be bad bulging scars develop, I have just seen terrible things in women from the sub-Saharan. Sewing herbs into the vagina can cause burns. In addition, in every form of FGM, the head of the clitoris, the visible part, is removed.

So even in the less radical case, a destruction of the woman's pleasure center.

Well, the invisible part of the clitoris is something as long as a little finger. It is possible that the woman will still have a fulfilling sex life afterwards. After all, sexuality is a multifunctional event.

And the most radical form?

In the so-called pharaonic circumcision, the labia and clitoris are removed and the vagina sutured except for a small opening. This makes everything painful and dangerous: urination, any penetration, menstruation, childbirth.

Where is this type of mutilation practiced?

In Somalia, Egypt, Yemen - since relatively little migration comes to us from there, I rarely have these cases in my practice. If I were to work in Paris, for example, it would look very different.

Is there some kind of geography of female genital mutilation?

The FGM belt is marked on maps of the World Health Organization, which is practically the high waistline of Africa. There are clear regional differences. In the Muslim north of Nigeria, for example, there is no circumcision, where mainly Christian tribes practice FGM. And in Sierra Leone it affects women of all religious communities. In my opinion, female circumcision has nothing to do with religion.

Christiane Tennhardt was trained as a gynecologist at the Charité, she worked for Doctors Without Borders for several years, including in Angola, Sierra Leone, Nigeria and Colombia. Until 2009 she was the head physician at the Berlin family planning center Balance, for which she continues to work as a freelancer and consultant.

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