Scholars of Arabic use the word “îzâr,” which means defect, and the word “hafd,” which means reducing and shrinking to express circumcision. Besides these, the words tahûr and tahâre are also used to express circumcision. European languages use the common expression female genital mutilation or circumcision to refer to circumcision. However, observations of some female mummies in Egypt and the description of circumcision on ancient Egyptian wall paintings supports the opinion that this tradition dates back very long and that it has continued for many years. The historian Herodotus states that circumcision was practiced by the Phoenicians, Hittites, and Ethiopians. Information obtained shows that circumcision is also practiced in the tropical regions of Africa, the Philippines, and by the tribes of the Upper Amazon and the women of the Australian Arunta tribe. The tradition of female circumcision that is originally a concept of the religions of African tribes has been associated with the religion Islam even though there is no reference to female circumcision at all in the Quran. Female circumcision is a violation of human rights. There is no legal explanation or excuse for persecuting women at young ages with various agendas like religion (!), customs and tradition or health in an area that affects their entire lives. This violation of women’s rights can also be interpreted as a violation of children’s rights.
- female circumcision
- women’s rights
- women’s health
Female circumcision or female genital mutilation has been defined by the world health organization as “all procedures that involve partial or complete removal of the external female genitalia, or other injury to the female genital organs for non-medical reasons” . Although the procedure is called female circumcision in the countries that perform it, its negative physical and psychological effects have led to the use of the Latin term “mutylatio” that means to maim, to cut off (mutilation) in the medical literature [2, 3].
There is very little information about the origin of female circumcision. However, observations of some female mummies in Egypt and the description of circumcision on ancient Egyptian wall paintings supports the opinion that this tradition dates back very long and that it has continued for many years.
The historian Herodotus states that circumcision was practiced by the Phoenicians, Hittites, and Ethiopians.
In addition to this, information obtained has revealed that circumcision is also practiced in the tropical areas of Africa, the Philippines and by the tribes of the upper amazon and the women of the Arunta tribe in Australia . The practice of circumcision is also called “tahara” in Arabic which means the procedure of cleaning. About the relationship between cleanliness and circumcision, the historian Herodotus asks, “where did the ancient Egyptians learn this, when the reproductive organs of all peoples on earth are remaining the same?”. It has also been pointed out that cleanliness came before beauty for the ancient Egyptians .
Type I: partial or complete removal of the preputium and/or clitoris (Sunna).
Type 2: excision of the clitoris together with the partial or total excision of the labia minora (excision).
Type 3: cutting nearly all of the labia minora and majora together with the clitoris and preputium and sowing the edges of the open wound together leaving only a small orifice for urine and menstruation blood to pass (infibulation).
Type 4: is an unclassified group and comprises other mutilating practices (piercing, pricking, tattooing, scraping, cauterization).
Many applications have been carried out in unhygienic conditions without anesthesia and mixtures of plants, cow dung and butter have been used for wound healing . Severe pain, bleeding, urinary retention, ulcers in genetical area, adjacent organ injury, sepsis and even death can be seen following procedures with scissors, part of glass, blade, bark, plant thorn performed by persons who do not medical professional training .
Infections, keloids, genital tract infections, sexual inherited diseases, especially genital herpes, increasing HIV infection risk, labor complications, sexual disorders and post-traumatic stress disorder can be listed among late period complications. Also, cases with Type 3 female genital mutilation are more risky since complaints such as requirement of deinfibulation, frequent recurrence, re-requirement of surgery, urinary retention, menstrual problems and painful sexual intercourse are frequently seen .
The symptoms of lower urinary system are frequently seen in females with Type 2 and 3 female genital mutilations . Decreasing in urinary flow rate depending on infibulation causes urinary stasis and therefore causes repetitive urinary infections. Consequently, formation of urinary or vaginal stone can be seen . In these cases, recommended treatment method is the deinfibulation. Urethral strictures or fistulas can be seen depending on urethral trauma during mutilation. In our case, urinary retention depending on adherences secondarily developed with mutilation was thought. It was observed that case urinated easily after deinfibulation operation. Cases with inability to have a sexual intercourse and therefore dyspareunia depending on improved vulvovaginal laceration and adherences in genital region after female genital mutilation performed in unhygienic conditions was reported . It has been thought that genital mutilation applications increase infertility by causing sexual disorders (dyspareunia, apareunia) and genital infections. In case control study, it was stated that there was a relationship between primary infertility and female mutilation . It was reported that psychological disorders such as secondary anxiety disorder and posttraumatic stress disorder against female genital mutilation could be seen .
Mutilation is still practiced in 30 countries in Africa, a few countries in the Arabian Peninsula, in some societies in southeastern Asia and secretly in ethnic groups that have migrated to Europe, America or Australia from these countries [2, 14]. Although the historical origin of this traditional practice is not entirely understood, there is evidence that it has existed since the ancient Egyptian civilization . According to the reports of the World Health Organization, approximately 100–150 million women alive have been subjected to these practices, 6000 African girls between the ages 4 and 12 are subjected to these practices every day, and 2 million new procedures are performed annually worldwide [1, 14].
In earlier studies it has been identified that FGM is performed as part of the culture and tradition (like an initiation rite into womanhood) or religion, to make finding a spouse easier, or for reasons like chastity, genital hygiene, high morality or virginity . It is known that circumcision is performed by Muslim, Christian, Jewish and also irreligious societies in Africa. In addition, no relationship was identified between religion and the prevalence of circumcision . The prevalence of circumcision in Muslim countries Egypt, Sudan, Somalia and some middle-eastern countries has led to the emergence of an opinion that circumcision is a recommendation and a requirement of Islam. Sudan is an Islamic Republic that applies Islamic rules in social life and government procedures. Thus, religious rules and principles have an important role in the lives of the Sudanese people. The sayings and deeds of religious opinion leaders and imams hold a significant value in the eyes of the public.
The expression circumcision that is the subject of this study refers only to female circumcision. The tradition of female circumcision that is originally a concept of the religions of African tribes has been associated with the religion Islam even though there is no reference to female circumcision at all in the Quran. The differences between religious systems in countries that practice female circumcision show that circumcision exists as a cultural phenomenon in other non-Islamic cultures. In this respect, it is believed that the tradition of female circumcision in Islamic African countries originates from African tribes. The highest levels of the tradition of female circumcision practiced by some African Animist groups in the pre-Islamic era have been encountered in the Yoruba and Bakango tribes. In addition to this, it is known that it was practiced widely in the era of the Kingdom of Kush ruled by Black pharaohs in Nubia in Upper Egypt during the time of the 18th dynasty. While Islam was spreading among the Animist tribes of Africa, the tradition of female circumcision influenced some schools of Islam through mutual interactions. Leaders of African tribes that converted to Islam and wanted to continue the practices of female circumcision associated it with Islam. Consequently, a belief that this practice is a requirement of Islam emerged .
2. History and methods
The practice of female circumcision differs by country and can be performed at any time starting from babyhood until the ages of 13–14 [7, 8]. In half of the countries circumcision is performed in, it is done before the age of 5 by a woman called a “daya,” usually without numbing the genital area and by using non-sterile tools like knives, razor blades, sharp pieces of glass or sharp edges of tin. Acacia thorns, bone nails, needles, strings made from animal hair or leather are used to close the wound, and then the girl’s legs are tied together tightly from the knee to the hip in an upright position. The circumcised girl lies without moving for a few weeks and is helped to urinate and defecate where she lies. During the circumcision, apart from the daya, other women gathered around the girl hold the girls’ arms and legs tightly, some press her shoulders down to prevent her from moving. To prevent the girl from swallowing or biting her tongue a cloth or stick is placed in her mouth, and the other women play the tambourine and sing songs loudly to mask the screaming [4, 9, 10].
According to the UNICEF report, around 125 million women have been circumcised to this day, and nearly 30 million girls are in danger of circumcision. Girls between the ages of 3 and 10 are subjected to this torture every year. Egypt (most prominently), Sudan, Ethiopia, Nigeria, Kenya, Indonesia, Malaysia, and Somali are among the countries where the tradition of female circumcision is practiced. It is rarer in Syria, Iraq and Iran and is also seen in Europe, Canada, America and Australia as a result of migration [9, 10, 12].
Our research revealed that female genital mutilation was used in past to treat some female disorders like hysteria, epilepsy, masturbation, lesbianism, sex addiction and mental disorders in the United States of America and west Europe [4, 13].
The social scientists studying this topic have separate views that support each other. Among these, there are opinions that female circumcision dates back to the Neolithic era, that the Egyptians used circumcision to prevent their relatives and slaves from getting pregnant and that it was also prevalent in the Arabian Peninsula before Islam .
Another aspect of the origin and spread of the tradition of female circumcision is the economic and geographic background. Harsh climate changes between Africa and the inner parts of Asia accelerated the replacement of the democratic and peaceful matriarchal society with a patriarchal society. As Nevâl es-Sa‘dâvî has also stated, during the era of the pharaohs Egyptian women held important positions in the field of governing as well as religion. Research conducted supports the opinion that ancient pagan gods were also female. However, the period of goddesses dates further back than the origin of patriarchal societies and feudalism. Women in ancient agricultural societies succeeded to preserve their social and political positions. However, the advancements in agriculture and its evolution into a means of living led to the birth of private ownership. The rise of class discrimination and the developments disrupted the position of women and made them lose their prior prestige and reputation. They were pushed towards the lower levels in all of the hierarchic systems .
The works of Nevâl es-Sa‘dâvî and Esma ed-Darîr on this subject have enabled access to first-hand reliable information and have facilitated raising awareness at a global level. Besides this, apprehension has increased with the development of feminist awareness and the international women’s health movement .
If we examine the religious aspect of female circumcision here, we must say that it is not included in any of the heavenly religions. However, there is also mention of inauthentic hadith on the subject of female circumcision. In one of these fake hadiths, it is reported that the prophet Muhammad (pbuh) summoned a woman that circumcised girls in Mecca and said, “do not cut too deep that is better for the woman and more liked by her husband . Besides this, according to a hadith narrated by Abu Hureyrah, the prophet (pbuh) said: The fitrah (human nature) is five things—circumcision, shaving the pubes, cutting the nails, plucking the armpit hairs, and trimming the mustache .” It is clearly stated that this expression does not concern female circumcision and that it was interpreted with bias. Those opposing the people that base this practice on religious requirements cite the Quran as a source for their opposing opinions. In this context they refer to the holy book that is the source of Islam and give examples from verses of the Quran (Surah [passage]:verse of the Quran; Furkan:2, Nur:115, Rum:30, Âli İmrân:6) .
One of the best arguments that female circumcision is prohibited in Islam is that the Quran and the sunnah (the verbally transmitted record of the teachings, deeds and sayings, silent permissions (or disapprovals) of the Islamic prophet Muhammad) of the prophet reject practices against human nature. In this context, female circumcision contradicts the systematic thought of the holy Quran .
The religious assessment should also include the fatwa (Islamic legislation) issued by renowned people and institutions of the Islamic community based on religious foundations that contradict these opinions. These are fatwa that state that female circumcision is legal in Islam and that its prohibition is unwarranted .
The continuation of the practice despite knowledge of its harms can be attributed to the culture and the associated emotional behaviors. When the condition is examined in Sudan, the country where female circumcision is most prevalent and where it is practiced in its most severe form, it will be seen that female circumcision is one of the most delicate subjects of that culture. In the Sudanese society where the pride of a family depends on virginity, being circumcised bears the characteristics of a cachet. In the Sudanese society, women must be virgins physically and symbolically, and this is possible with circumcision .
Although it is incorrect according to religious references, the opinion that women are a source of mischief and that they should be kept under control that is customary in Muslim societies plays an important role in the continuation of female circumcision in the countries it is practiced in. In a society where non-circumcised women are regarded as prostitutes, the highest authority in the family, the grandmothers continue this practice that is an indispensable aspect of their culture to them. Because it is a matter of honor and pride for the family they themselves deliver the girls to the dayas.
According to Nevâl es-Sa‘dâvî, economic reasons play an important role in the origination and persistence of female circumcisions. The historical process shows that the oppression of women began with the evolution into a patriarchal society. The economic interests of society and the moral and religious values of the patriarchal system overlapped and gained support. Historical research shows that chastity belts, circumcision and other forms of violence were methods used to suppress female sexuality. It was aimed to restrain female sexuality and women were not allowed to experience sexuality unless it was for economic reasons. The daya and doctors that earn a living by performing these procedures must also be remembered among economic reasons. The fact that women in Sudan suffer this procedure multiple times due to reasons like marriage, birth, divorce, and re-marriage displays the economic dimensions concerning the practitioners of circumcision. It is known that daya are also required the wedding night .
The subject of circumcision is directly related to female sexuality. Together with the most delicate subjects of society, religion and policy, this relationship is more prominent in less developed countries. Girls that are circumcised are turned into targets vulnerable to physical and mental abuse without the capacity of thinking, understanding and judgment.
Cultural, social, psychological and economic conditions appear to be the major factors in persisting the practice of female circumcision. Esthetic concerns may also be added to these factors. It is also stated that the concepts of tradition and religion are also strong encouragers . In addition to this opinion, many of the Muslims and academics in the west argue that circumcision is more related to culture than religion. Likewise, the authentic and apodictic references of Islam reject female circumcision. Accordingly, the philosophy of Islamic law (fiqh) only accepts circumcision of boys known by the name “hıtân.” Unfortunately, it can be seen that the religion has been manipulated to express that female circumcision is a religious requirement in many countries in Africa .
Raising public awareness has a major importance in combating female circumcision. While the public is enlightened religiously and medically, the rights of women in this area must be protected legally through legal enforcement. The Egyptian Mufti Office has announced that they are against female circumcision and that this practice has no religious basis. Similarly, the Religious Affairs Administration of the Republic of Turkey also states that female circumcision is a procedure that the religion Islam prohibits. At this point, the explanations of Nevâl es-Sa‘dâvî are important in the religious and medical aspects: Religion comprises the concept of health, love, justice, equality and honesty for all people, man or woman. Thus, a religion that desires to harm and sicken the bodies of girls and women is unthinkable. How could religion order to cut off an organ created by Allah? No organ or anything else is created by Allah randomly . Islam does not allow human nature to be disrupted. On the other hand, male circumcision has been categorized as Sunnah and wajib (that which is proven on the basis of ambiguous evidence) on the basis of Islamic law and certain health benefits.
The importance of informing the public and education in ending the practice of female genital circumcision that has no religious basis and endangers the future of children and affects them is evident. Also, the society must acquire a high level of consciousness with the capacity to handle and resolve the problems of children to protect them instead of maiming them by circumcision. Families that want these harmful customs and traditions to come to an end want to enlighten the public and also demand laws and punishments that the whole society will be bound by.