Thesis: Female Genital Mutilation and Violence Against Women

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FGM

FEMALE GENITAL MUTILATION

Violence against Women

IDENTIFICATION of the POPULATION:

While the population for this study is women worldwide, since gender violence is a matter for all women, that particular focus for this research is the topic of FEMALE GENITAL MUTILATION. Certain cultural pockets both in Africa and the Mid-East have practiced what is know culturally as female circumcision, but also now referred to as of Female Genital Mutilation (FGM), usually by those who do not practice it. There are variations as to how and who performs these surgeries; frequently they are preformed without anesthesia and by unlicensed surgical practitioners, often by midwives or other family members. It is a tradition that usually goes back many generations and its origins are often quite difficult to discern. In fact it predates both Islam and Christianity as evidenced by a Greek papyrus in found in Egypt dating from circa 163 BCE (Lane & Rubinstein). While many cite it as a religious practice there is often little or no references to the procedure in any original religious text such as the Koran. (Muslim Clerics) This practice is touted as a rite of passage for women who vary in age from eight to fourteen and includes the removal of the clitoris and labia and sometimes entails the suturing of the vaginal cavity as well, leaving only enough room for urination. The latter surgery is undone upon marriage often proving that the wife has remained a virgin until that time, one of the primary purposes of the ritual.

This practice is so deeply imbued in many cultures that it is simply the norm:

Circumcision is often cited as a necessary prerequisite for marriage, and there are numerous additional explanations for the practice.... Perhaps the most important rationale for female circumcision is that because it is such an ancient and commonly practiced tradition, reduced or infibulated genitals are simply considered normal. Indeed, when Sudanese or Egyptian villagers have discussed the custom with female Western researchers, they have been shocked to discover that the female researchers have not themselves been circumcised. (Lane & Rubinstein 31)

These practices are often physically harmful and many cultures are seeing them as increasingly appalling with reference to the rest of the world and to women's human rights in particular. However, the practice continues not only in other countries, but here in the United States as well. Many immigrants who practice this cultural ritual feel even more strongly that it be preformed on women who are in other countries in order to keep them safe.

Doctors in countries where this practice usually occurs in unsanitary and unsafe conditions, have tried to mitigate complications from unlicensed practitioners by using hospitals to perform the operation more safely, but this has also met with much criticism:

The procedures are increasingly being performed by physicians, who often claim that they are minimizing the harm that would potentially result if the procedure were performed by traditional operators. Arab and African feminists strongly condemn the medicalization of female circumcision, which they believe will promote its continuation rather than its abandonment. (Lane & Rubinstein 31)

It is important to remember that most societies that practice FGM view it as natural as removing someone's appendix was in the early to middle twentieth century. They even feel that the appearance of the woman is greatly improved by the procedure. By allowing hospitals to perform the surgery, this further promotes the feeling of legitimacy. Couple that with an apparent religious affiliation and, depending on other cultural mores, this can be a difficult hurdle to overcome:

In Kenya, women's decisions to have their daughters circumcised are associated with various individual and community-level characteristics, such as education, media exposure and ethnicity, according to an analysis of data from a national survey.1 Overall, 38% of women reported experiencing genital cutting, and 46% of circumcised women already had or planned to have their daughters circumcised. (Rosenberg 151)

In regards to the case study presented, Nawal is certainly feeling great pressure from many of her older family members to have her daughter go through this procedure. And although touted largely as a matrilineal decision, the males certainly want to promote FGM as a means of control over their female offspring and to assure that the women they marry have remained virgins. As a healthcare professional I would have to emphasize the risk to the daughter and evaluate Nawal's own cultural perceptions regarding it. Residing in the U.S. For five years and having a thirteen-year-old daughter probably means neither are U.S. citizens, which could mean that returning to the Sudan is a possibility and also may influence this decision. However, after five years of exposure to this culture there may be a window of opportunity to have her see FGM in a new light and that would certainly be the avenue a healthcare professional should traverse when dealing with this situation. After all, the studies on this topic have shown that."..the likelihood that a mother would decide to have her daughter circumcised decreased as her level of education and exposure to media rose." (Rosenberg 151) Therefore, the more educated a mother is regarding this procedure and the more exposure to other cultural norms they have, the less likely they are to force their daughters through this archaic and controlling ritual.

CLINICAL QUESTION:

From a best practices point-of-view, what is the best way to address the elimination of this cultural violence against women? Many issues have to be resolved before even broaching the subject on a national level. While the global community seems in accord with outrages against this practice, actually convincing the cultures that perpetuate it is a daunting task.

LITERATURE REVIEW: SYNTHESIS and ANALYSIS

FGM OVERVIEW, PERSONAL STORIES & DANGERS:

MAGDA was 13 years old when her mother and a group of female neighbours held her down while a local doctor circumcised her. "All the women were holding my arms and legs... I was crying and screaming... It was a hideous and painful experience, she recalls. (Ezzat, 1994, p. 35)

This is certainly a generalized experience for women who have undergone the ritual "coming of age" process know politely as female circumcision but globally as Female Genital Mutilation. Through this experience women are expected to become more cooperative members of their society by curtailing the possibility of any overt sexual desire or experience so as to assure their virginity and future promise of a good marriage. It has been the topic of the political scene for several decades as well as the art world.

Deep Cut," is a play by Karim Alrawi who explores the issue from a more creative perspective and addresses not only the process but the need for asylum to be granted to women wishing to escape the process in their won countries. One character in the play, Dr. Andrew Hepburn, one is of the opinions that he believes in a prime directive, such as the one espoused on "Star Trek" and violated on almost every show, and feels that no culture has the right to interfere with another for any reason. Another character, Dr. Chan, is there to challenge that notion. He was tortured after his involvement in the Tiananmen Square protests, and he is appalled that Andrew's belief in his prime directive would have prevented the Americans from coming to his aid. (Pressley, 1996, p. 15) This, creatively stated, is the crux of the current social and political issue.

Alice Walker also took up the crusade in her novel, Possessing the Secret of Joy, in which she describe the psyche and experience of her main character faced with undergoing the tradition. In a panel discussion of the book and the topic Gloria Steinem also adds the gender perspective on the issue:

female genital mutilation is a demonstration of patriarchy at its worst, a metaphor for the "psychic mutilation" that women suffer everywhere at the hands of their male "oppressors." Just as African patriarchs have fashioned a brutal practice that would ensure the virginity of their brides, the "spirit-killing regimes of male dominance" in the West rob women of their "reproductive rights" by seeking to outlaw abortion, by insisting on unnecessary mastectomies and Caesarean births, by demanding a kind of subservience that kills the rebellious high-spiritedness of little girls, and so on. (Eichman, 1992, p. 52)

Those voices with a culture, like this man from Egypt, have this to say:

It is all a part of men's everlasting attempts to maintain the upper hand and - in consequence the patriarchal class system," says Al-Saadawi. "I would not have married my wife if she had not been circumcised, said an employee in the ministry of electricity. To him a uncircumcised woman is a "reflection of an immoral background and future." (Ezzat, 1994, p. 41-42)

Female genital mutilation is practiced in some Asian and North and Central African countries, as well as by immigrant groups (mainly Muslim) in some Western countries as well. According to the World Health Organization's report of 1996, FGM is… [END OF PREVIEW]

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