It is a term that often confuses people. When you hear the word "circumcision," your mind probably jumps straight to a common procedure done on newborn boys in hospitals across the world. But when we talk about what is circumcision of a woman, we are entering an entirely different territory. It isn’t just a "female version" of the male procedure. Not even close.
In reality, the medical community and international human rights organizations like the World Health Organization (WHO) almost exclusively refer to this as Female Genital Mutilation or Cutting (FGM/C).
Why the name change? Because the biological reality is drastically different. While male circumcision involves removing the foreskin, the practices categorized under female circumcision often involve the partial or total removal of sensitive external genitalia. It’s a heavy topic. It’s uncomfortable. But understanding the nuances of what this actually entails is the only way to have an informed conversation about women's health and human rights.
The Different Types: It’s Not Just One Thing
Most people think of this as a single type of surgery. It's not. The WHO breaks it down into four distinct categories, and the severity varies wildly between them.
Type I is often called a clitoridectomy. This is the partial or total removal of the clitoral glans. Sometimes, it’s just the prepuce (the fold of skin surrounding the clitoral glans) that is removed. If you’re looking for the closest anatomical parallel to male circumcision, this is technically it, though the physiological impact on sexual response is significantly more profound.
Type II goes further. This is known as excision. Here, the clitoral glans and the labia minora are removed, sometimes with the labia majora. It’s extensive.
Then there is Type III, the most severe form, known as infibulation. This involves narrowing the vaginal opening by creating a seal. The wound is created by cutting and repositioning the labia minora or labia majora, sometimes through stitching. A small opening is left for urine and menstrual blood. Imagine the complications. Think about the pain during menstruation or later, during childbirth. It’s a lifelong physical burden.
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Type IV is a "catch-all" category. It includes all other harmful procedures performed on the female genitalia for non-medical purposes. We’re talking about pricking, piercing, incising, scraping, or cauterizing the area.
Where and Why Does This Happen?
You might think this is strictly a "foreign" issue. It’s easy to distance ourselves. But the reality is that FGM occurs globally. While it is most concentrated in 30 countries across Africa, the Middle East, and Asia, migration patterns mean that healthcare providers in the US, UK, and Europe encounter survivors every single day.
According to UNICEF data, over 230 million girls and women alive today have undergone some form of these procedures.
The "why" is complicated. It’s rarely about malice. Usually, it’s about tradition. In many communities, it’s seen as a rite of passage. It’s a prerequisite for marriage. There’s often a belief that it preserves a woman's chastity or "cleanses" her. In some cultures, the uncircumcised female body is viewed as unhygienic or overly masculine.
Dr. Nawal Nour, an Associate Professor at Harvard Medical School and founder of the African Women’s Health Center, has spent her career educating Western doctors on how to treat survivors with dignity. She emphasizes that for many women, this wasn’t a choice made by an individual, but a requirement imposed by a social structure they had to navigate to survive and belong.
The Health Consequences Nobody Wants to Talk About
The immediate risks are terrifying. Since these procedures are often performed by traditional practitioners using non-sterile tools—think razor blades, glass, or sharpened stones—hemorrhage is a massive risk. So is sepsis. In areas without quick access to emergency care, these complications can be fatal.
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But let’s talk about the long-term stuff.
- Chronic Pain: Scar tissue in a highly sensitive area doesn't stretch well. It hurts to sit, walk, or exercise.
- Urinary Issues: If the opening is narrowed, urine can back up. This leads to frequent UTIs and even kidney stones.
- Childbirth Complications: This is the big one. For women with Type III, the tissue must often be cut open (defibulation) to allow the baby to pass. If not, the labor can be obstructed, leading to maternal death or fistula.
- Psychological Trauma: PTSD is common. Many women describe a sense of betrayal by the elders or family members who organized the procedure.
Challenging the Myths
There is a persistent myth that what is circumcision of a woman is a religious requirement. This is factually incorrect. While some practitioners claim it is mandated by Islam or certain sects of Christianity, scholars from Al-Azhar University in Cairo—one of the most prestigious centers of Islamic learning—have issued fatwas against the practice. They state clearly that it has no basis in the Quran and is actually contrary to the Islamic principle of not harming the body.
It’s a cultural practice that has hitched a ride on religious identity, but it isn't "faith."
Another myth? That it "doesn't really hurt" if done to an infant. Science tells us otherwise. The neonatal nervous system is fully capable of experiencing intense pain, and the trauma of that pain can have long-lasting effects on brain development and stress responses.
The Shift Toward Ending the Practice
Things are changing. Since the late 20th century, there has been a massive global push to criminalize FGM. Countries like Egypt, Ethiopia, and Sudan have passed laws banning it. But laws only go so far. You can't just arrest your way out of a thousand-year-old tradition.
The real progress happens at the grassroots level. Organizations like Tostan, operating in West Africa, use "Community Led Development" models. They don't walk into a village and tell people they are "wrong." Instead, they facilitate discussions about human rights and health. When the whole village—including the men and the traditional cutters—decides together to stop, the practice actually ends. If only one family stops, their daughter might not be able to marry. If the whole village stops, the social pressure vanishes.
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How Healthcare Providers Can Help
If you are a medical professional, your role is crucial. Many survivors are hesitant to seek care because they fear being judged or gawked at by doctors who have never seen "what is circumcision of a woman" in person.
The goal isn't to "fix" the woman as if she is broken. The goal is to manage her symptoms and provide options. This might include:
- Defibulation: A surgical procedure to open the scarred vaginal area, improving quality of life and making childbirth safer.
- Clitoral Reconstruction: A specialized surgery, popularized by doctors like Pierre Foldes, which aims to restore some sensation and anatomy. It's not a "reset button," but for many, it's a vital part of reclaiming their bodies.
- Culturally Sensitive Therapy: Counseling that acknowledges the cultural weight of the experience without pathologizing the survivor's background.
Actionable Steps for Awareness and Support
Understanding the reality of this practice is the first step toward supporting the millions of women affected by it.
- Use the Right Language: While "circumcision" is the term used by some communities, using "Female Genital Mutilation/Cutting" (FGM/C) helps align the conversation with medical and human rights standards.
- Support Grassroots Organizations: Look for groups like Forward UK, Orchid Project, or Tostan. These organizations work directly with communities to change the social norms that keep the practice alive.
- Educate Without Shaming: If you're talking about this, remember that many survivors don't see themselves as "mutilated." They see themselves as women who underwent a traditional rite. Shaming the culture often makes people defensive and less likely to listen to health warnings.
- Listen to Survivors: Seek out the voices of activists like Jaha Dukureh or Waris Dirie. Their first-hand accounts provide the nuance that statistics cannot.
If you or someone you know is seeking medical advice related to FGM/C, it is vital to contact a specialized clinic. In the US, the U.S. Network for Ending FGM/C provides resources for both survivors and healthcare providers to ensure that care is informed, respectful, and safe. Knowledge is the most effective tool we have to protect the physical integrity and health of girls worldwide.
Next Steps for Further Understanding
To deepen your understanding of this issue beyond the basics, you should research the specific legal frameworks in your own country regarding "vacation cutting," which is the practice of sending girls abroad to undergo the procedure. Understanding the legal protections available is a practical way to support local advocacy and protection efforts.