Introduction
Female circumcision (also known as female genital mutilation (FGM)) is a dangerous traditional practice that involves removing or cutting the external genitals of a female. This practice is typically performed across community cultures with a patriarchal structure. According to the existing anthropological research, the history of FGM most likely began in Egypt, approximately around the fifth century BC (Duivenbode & Padela, 2019). The whole practice is directly associated with the issue of gender inequality. Some of the researchers also link the advent of FGM to the west coast of the Red Sea (Fox & Johnson-Agbakwu, 2020). Overall, both Christian and Islamic communities have been found to treat FGM as a religious practice that should be carried out for allegedly divine purposes.
Essential Components of Female Circumcision
There are four types of FGM that have to be considered:
- Type I: Clitoridectomy. The prepuce and the clitoris are both removed either partially or completely.
- Type II: Excision. The labia minora (in some cases, together with the labia majora) and the clitoris are removed partially or totally. The amount of the removed area varies depending on the community.
- Type III: Infibulation. A covering seal is introduced to narrow the vaginal orifice. This is done using the labia minora and the labia majora as the seal. Removal of the clitoris is not necessary in this case.
- Type IV: Harmful Procedures with Non-Medical Purpose. These include cauterization, piercing, scraping, and pricking (Johnson-Agbakwu & Manin, 2021).
There are three additional components related to FGM:
- Incision: Refers to the cuts that are made in the clitoris or the vaginal wall.
- Deinfibulation: Refers to cutting open a female that was infibulated with the goal of facilitating childbirth or allowing intercourse.
- Reinfibulation: Refers to the follow-up practice where the external labia are sewn back together.
Factual Data
According to Hamid et al. (2018), at least 200 million females of different ages (who are alive today) have undergone FGM. The majority of FGM practices are carried out before girls turn 15 years old. The overall at-risk population exposed to FGM is approximately three million females (Duivenbode & Padela, 2019). The most influential factor affecting the prevalence of FGM is ethnicity, as most cases of Type III FGM occur in Ethiopia, Sudan, Somalia, and Djibouti. Type I, II, and IV are mostly popular in Burkina Faso, Mali, and Guinea (Klein et al., 2018). Thus, there can be a rather large extent of African American women who have been exposed to at least one of the FGM types during their lifetime.
Additional Evidence
The biggest contributor to the prevalence of FGM is the popularity of specific social conventions that motivate the locals to continue the practice. In line with Fox and Johnson-Agbakwu (2020), there are various scenarios where FGM is considered necessary in order to prepare a girl for adulthood and marriage. Therefore, African females might have an altered set of beliefs regarding proper sexual behaviors. Even though modesty and femininity are often associated with FGM, the practice itself is dangerous and poses a number of health risks that are rather hard to mitigate (Onsongo, 2017). The biggest argument protecting the existence of FGM is the need to uphold cultural traditions.
Impact on Health
The immediate health impact related to FGM includes shock and pain that is also complemented by possible wound infections and septicemia. According to Hamid et al. (2018), various infections and hemorrhages could be severe enough to cause the death of the female patient undergoing the FGM procedure. Additionally, long-term implications of FGM might include dyspareunia, childbirth complications, genital hypersensitivity, and sexual dysfunction (Johnson-Agbakwu & Manin, 2021). Therefore, FGM is a dangerous practice because it imposes limitations on the given female and makes it harder for her to live normally.
Indirect impact on health could be associated with behavioral disturbances experienced by females who underwent FGM while being under 15 years old. The amount of psychological stress associated with the procedure could make them lose confidence and trust in caregivers completely (Duivenbode & Padela, 2019). The majority of African women undergoing FGM are rather likely to suffer from depression and anxiety later in life (Klein et al., 2018). As a consequence of sexual dysfunction, females could experience a higher rate of divorces and various marital conflicts.
Beliefs and Benefits
There are numerous beliefs that can be associated with FGM and support the need to perform female circumcision. First, there is an idea that a woman’s sexuality could be controlled to the extent that it could improve male sexual pleasure (Fox & Johnson-Agbakwu, 2020). As a part of an important cultural heritage, FGM remains deeply connected to the concept of womanhood. Religious beliefs tend to play an important role as well since various doctrines still justify the practice (Onsongo, 2017). Additionally, there are two questionable benefits that can be addressed when discussing FGM: improved hygiene and better socioeconomic positioning. Evidently, FGM practices also serve as a definite source of income for practitioners.
Risks and Concerns
FGM practices bring out quite a few risks and concerns that have to be considered when addressing female health. The increased risk of bleeding during intercourse, for example, is one of the facilitating factors for the development of human immunodeficiency virus (HIV) (Hamid et al., 2018). The advent of issues related to female sexual function is another area where risks are overwhelmingly dangerous. African women might be prone to pain during sex, absence of orgasm, and generally decreased sexual desire (Johnson-Agbakwu & Manin, 2021). The biggest concerns for females who have undergone FGM are childbirth complications and mental health problems. It is noted by Onsongo (2017) that the FGM experience leaves women traumatized to the extent that they could come up with somatic complaints and post-traumatic stress disorder.
Response Plan
In order to create a response plan to help African women overcome the issue of FGM and its prolonged impact on women’s everyday lives, it will be essential to establish community-led education. This should be the first step toward a detailed response plan to the concerns identified above, as more networking efforts are going to be deployed (Klein et al., 2018). The government should attempt to abandon FGM completely and de-link it from religious beliefs. Females from all over the country should be able to receive relevant guidance and support. An updated medical education curriculum could be released to ensure that FGM causes no complications for women who have already experienced it (Hamid et al., 2018). Healthcare worker training and referral systems can be developed and deployed to strengthen the anti-FGM force. In the words of Johnson-Agbakwu and Manin (2021), national policies and mass media could be utilized to abandon FGM completely. A complete community transformation will be required to change public opinions and perceptions.
The primary responsibility of the APRN and HC will be to develop new evidence-based treatment guidelines and ensure that personal health capacities are considered. One of the significant areas of improvement that has to be covered is the ability to adhere to updated guidelines and protocols (Fox & Johnson-Agbakwu, 2020). Another responsibility is to extend the knowledge base and redefine the socially constructed acceptance of FGM (Duivenbode & Padela, 2019). These health providers will be required to train and inform women and girls exposed to the outcomes of FGM in order to condone such practices completely.
Conclusion
Based on the evidence from the current presentation, it is safe to say that healthcare providers should receive training to be able to classify FGM and eradicate it gradually. Constant needs assessments are to be completed across the United States in order to mediate cultural differences affecting African American girls and women. The number of health risks associated with FGM cannot be ignored because it could lead to serious injuries and deaths among one of the most vulnerable populations in the country.
References
Duivenbode, R., & Padela, A. I. (2019). Female genital cutting (FGC) and the cultural boundaries of medical practice. The American Journal of Bioethics, 19(3), 3-6. Web.
Fox, K. A., & Johnson-Agbakwu, C. (2020). Crime victimization, health, and female genital mutilation or cutting among Somali women and adolescent girls in the United States, 2017. American Journal of Public Health, 110(1), 112-118. Web.
Hamid, A., Grace, K. T., & Warren, N. (2018). A meta‐synthesis of the birth experiences of African immigrant women affected by female genital cutting. Journal of Midwifery & Women’s Health, 63(2), 185-195. Web.
Johnson-Agbakwu, C. E., & Manin, E. (2021). Sculptors of African women’s bodies: Forces reshaping the embodiment of female genital cutting in the West. Archives of Sexual Behavior, 50(5), 1949- 1957. Web.
Klein, E., Helzner, E., Shayowitz, M., Kohlhoff, S., & Smith-Norowitz, T. A. (2018). Female genital mutilation: Health consequences and complications – a short literature review. Obstetrics and Gynecology International, 2018. Web.
Onsongo, N. (2017). Female genital cutting (FGC): Who defines whose culture as unethical? IJFAB: International Journal of Feminist Approaches to Bioethics, 10(2), 105-123. Web.