This review looks at Western and African literature to identify the most common assumptions, myths, and truths behind why female genital mutilation (FGM) continues amongst practicing communities. This paper also explores how social norm practices contribute to the continuation of this traditional practice.
Keywords: female genital mutilation, traditional practices, social norms, cultural practices
Female genital mutilation/cutting (FGM/C) is a cultural tradition practiced within 29 East African and West African countries. While there is no exact date recorded of when this practice first began, all research shows that it has been an ongoing practice for thousands of years. This cultural ritual is practiced on young girls between the ages of infancy to 15 years. According to the World Health Organization (WHO) (2008), 100 to 140 million girls and women around the world have undergone this procedure which involves the removal of the female genitals, specifically the clitoris. As a result of this procedure, many women have suffered emotional, physical, and psychological long-term and short-term negative effects. Low self-esteem, reproductive difficulties, sexual challenges, sickness, disease, and ultimately death in some cases are outcomes of the FGM/C procedure (WHO, 2008).
The reasoning behind this cultural practice stems from religion, cultural rites of passage, and social norms. For many, FGM is a generational practice that has been passed on; for others, it is a new phenomenon that demands further explanation as to why it is a continued practice. Many international organizations such as the United Nations, Save the Children, and UNICEF have made it their mission to stop FGM in countries where it is still an ongoing practice. FGM is a global problem that affects the lives of girls and women, young and old. Advocacy and protests in support of child protection rights, women’s health, and human rights have been made in an effort to encourage the abandonment of the FGM practice. However, despite all the laws, policies, protests, deaths, and punishments directed toward discontinuing the practice, it continues in many countries.
This literature review explores several qualitative research journal articles and theoretical frameworks in an attempt to understand how changes in social norms, behaviours, and attitudes contribute to the continuation/discontinuation of FMG practice. An attempt is made to provide a clearer understanding of the proposed research topic and to investigate the literature reports about FGM. This literature review explores the deeply-rooted question of why FGM is a continued practice. Many of the studies that have been conducted thus far have focused on the female perspective of FGM, the after-effects of the procedure, and the rationale for discontinuing the practice. However, little research has focused on how changes in social norms affect the ongoing practice of FGM.
The following research question and corresponding sub-questions guide an exploration and examination of the literature surrounding this topic:
What roles do social norms play in the ongoing practice of FGM?
- How does gender play a role in the decision-making surrounding FGM?
- What roles do community leaders play in continuing/discontinuing the practice of FGM?
The researchers referenced in this literature review are from both Western and African societies. The range of perspectives from various regions of the world gives this literature review a well-rounded approach toward the myths, misconceptions, and assumptions surrounding FGM. Attitudes and cultural social norms which play a role in the prevalence of FGM can be classified into four main categories: hygienic and aesthetic, psychosexual, spiritual/religious, and socio- cultural (Le Charles, 2016, p. 104). Based on their surroundings and environment, FGM participants in certain practicing communities agree to the continuation of the practice (UNICEF, 2010, p. 5). To erase or to force abandonment of FGM may be difficult because many FGM supporters are firm believers in the benefits and rights of the practice. Since FGM is socially accepted within certain communities, it is possible that FGM supporters would not change their attitudes because they simply see no fault in the practice (Shweder, 2000). For some, FGM may also be seen as inherently protective or necessary for full female development. In contrast, those who condemn this practice are usually from external communities and thus do not hold the position of decision-maker in participating communities (Ahmed, Al Hebshi, & Nylund, 2009).
Literature shows that FGM actually plays an important role in the cultural identity and religion of women in certain communities. According to Shweder (2000), “most African women do not think about circumcision in human-rights terms. Women who endorse female circumcision typically argue that it is an important part of their cultural heritage or their religion” (p. 217). One study reports, “…Of the women who were circumcised, 96 percent said they had circumcised or would circumcise their daughters” (Shweder, 200, p. 217). From a Western stance, FGM is a dangerous and harmful procedure that mothers would not want their daughters to undergo; however, based on evidence from the literature, most women who have undergone the procedure would want the procedure carried out on their own daughters (Babatunde, 2017, p. 17). Literature also shows that uncircumcised women are often banished from the community or not allowed to marry. Moges (2009) points out “the close relation between marriage and FGM… [where] uncircumcised tribe members cannot marry and are ostracized by the community and tribe” (p. 4).
Research also shows how women who undergo FGM actually see it as a way to become more feminine. The removal of the clitoris brings a sense of womanhood and separates women from their male counterparts, an outcome which some women claim feels liberating. According to Shweder (2000), from the female perspective, FGM represents the full female identity, power, marriage, and motherhood. Many people are unaware of the strong cultural stance of women who appreciate FGM’s representation of empowerment and feminism. This opposes the more popular cultural feminist approach of anti-FGM for its disempowerment of women. Less popular are the studies that show how some women embrace the cultural practice. Some women believe that if the procedure is performed hygienically and correctly in a safe medical environment, FGM can actually be an uplifting practice (Ahmed, Al Hebshi, & Nylund, 2009). Shweder (2000) explains that FGM is supported and celebrated by those who undergo the cultural practice; furthermore, FGM should not be abandoned because it is seen as wrong in the eyes of those who do not understand the practice. However, the support of this notion is not widespread.
Arguably, the Western lens will view a cultural practice as wrong and expect it to change and fit their criteria of what is right. This view is evident by the protests, campaigns, laws, and policies in Western countries for the abandonment of FGM practice. In contrast, the literature shows that in some communities FGM is an eagerly anticipated rite of passage for girls entering womanhood. According to Shweder (2000), adolescent girls look forward to celebrating this cultural rite of passage with family. Many people are unaware of FGM’s significance as a young girl’s rite of passage.
Practitioners of FGM are commonly viewed as an uneducated, oppressed group of women practicing a dangerous nonmedical cultural procedure (Blanco et al., 2013). Many critics wonder how women can continue this practice. According to Shweder (2000), the practice is controlled, performed, upheld, and supported by women, while men have very little to do with the decision-making surrounding FGM. Women are the cultural experts. According to Ahmed et al. (2009), “…decisions about FGM/C continue to be in the hands of grandmothers and mothers” (p. 22). A misconception of FGM is that women are victims of a violent act, yet in this case the women are both the oppressed and oppressors.
The process of adapting to a new culture is another common theme in the literature as this experience plays a role in the attitudes toward FGM. The literature also shows that geography may have an impact on social norm changes (Blanco et al., 2013). According to Johnsdotter (2008), the distance between where people live and their country of origin can contribute to their shift in attitudes. This effect occurs because one’s sense of belonging to the new society has a significant role in one’s adaptation of new customs and also in the shedding of traditional customs (2008). The farther away people live from their country of origin, the less likely they are to continue certain behaviours and customs. The farther away people live from their country of origin, the easier it is to resist the pressures of behaving according to expectations established by the culture of origin. For example, if the diaspora is far from their original community, it is easier for members of the diaspora to resist the pressure of continuing certain practices. As well, one’s sense of belonging to the new society plays a significant role in one’s adaptation of new customs (Blanco et al., 2013). As reported by Johnsdotter (2008), “In Canada, African immigrants explained that distance from families and acculturation to Canada caused them to change views on FGM” (p. 118). Removing oneself from a familiar environment and adapting to another environment can impact one’s view of a particular cultural practice.
This shift in attitude toward FGM has been exemplified by Eritrean and Ethiopian people living in Sweden, many of whom recalled that the practice of FGM was left behind upon their arrival to Sweden (Johnsdotter, 2008). These immigrants rationalized that their children who were born in Sweden were Swedish and would thereby follow the Swedish customs and rules. In fact, parents actually worried that members of the older generation in their home countries would try to circumcise their Swedish daughters. It is interesting to note that those who had previously supported FGM were now against FGM and had rejected the practice. They claimed that being Swedish was an important part of their identity and self-image; therefore, their identification with their country of settlement had formed the foundation of their rejection toward FGM. However, Somali Swedes still retained some positive cultural aspects of FGM (Johnsdotter, 2008). According to Morgan and Pearson (2017), if your new host country has a different way of expressing or celebrating a rite of passage, then you often tend to shift your views and adapt new cultural practices. Yet despite these trends, the Nigerian diaspora has not abandoned FGM. Could it be the tight-knit nature of the Southwestern Nigerian community that makes it so difficult for these communities to leave behind old traditions?
Contemporary literature tends to link FGM to religion, claiming that Muslim women undergo FGM out of religious obligation (Ostrom, 2014). According to Gele et al. (2012), the religious aspect plays the strongest role in the attitudes toward FGM. However, studies have shown that there is no direct link between FGM and religion, specifically Islam (Ahmed, Al Hebshi, & Nylund, 2009). There is no written statement in the Quran that women must undergo FGM. In fact, the Quran only states that one should be clean and purified, especially during prayers. According to the Quran, “truly God loves those who turn unto him in repentance and loves those who purify themselves” (2:222). Although FGM is not specifically addressed in the Quran, it is perceived as an Islamic requirement. Moreover, those who practice FGM have shown themselves to be very religious. In Muslim context the practice of FGM may symbolize a way to maintain purity. However, this connection between purity and FGM may be a misconception because there is no direct link between them. Therefore, this idea of de-linking religion from FGM could play a role in whether the practice is continued or not. Some Muslim men, convinced by the opinions of religious scholars and sheikhs de-linking FGM and religion, have come to agree that there are no religious grounds to continue the practice of FGM (Mackie & Moneti, 2014).
Studies in the literature relevant to the context of this project focus on topics of child safety, women’s health, human rights, freedom to practice cultural traditions, attitudes, and cultural social norms. Child safety plays a vital role in FGM as many participants who involuntarily undergo this procedure are young female infants as young as two weeks old. These procedures are often practiced in unsanitary environments by untrained health professionals with little to no knowledge of anaesthesia or recovery aftercare. Therefore, female infants are placed in precarious positions where they are at risk for complications, infections, pain, and ultimately death resulting from excessive loss of blood.
According to Gage (2015), anti-FGM legislation has the ability to change attitudes toward FGM (p. 11). Studies have shown that strong law enforcement at the governmental level can influence the attitudes and behaviours of those who practice FGM. Once the legal consequences are stated at the governmental level, people may become more apprehensive about committing or undergoing such procedures. Although anti-legislation could change attitudes toward FGM, results from the literature suggest that legislation is not enough. According to Dalal et al. (2015), legislation must be incorporated with education to create adequate awareness among these communities that continue to practice FGM (p. 166).
According to Blanco et al. (2013), issues of female genital mutilation/cutting (FGM/C) are usually discussed secretly or only among women in the communities where these practices are deeply rooted. More often than not, the perspectives of men are not acknowledged. Even though the issue mainly concerns women, men could be influential in the continuation or discontinuation of this practice. In fact, this study concludes that men do play a significant role in the abandonment of FGM/C. In order to properly explore this gender gap in the research, a transversal descriptive study was designed to examine Gambian men’s knowledge and attitudes toward FGM/C along with related practices in their family/household (Blanco et al., 2013). The results showed that ethnic identity was the leading factor in shaping how men understand and value FGM/C. Many supporters of the continuation of FGM/C belong to traditionally practicing ethnic groups. Many men in this study would encourage the continuation of FGM/C for their daughters, although it was revealed that these men had low involvement in the decision-making process with very few making the final decision (Blanco et al., 2013). According to the authors,
…in a recent study conducted in The Gambia with health care professionals, it was discovered that FGM/C found higher support among men. While women would give more strength to the deep cultural roots of the tradition, men seemed privilege to a moral perspective, prioritizing the fact that the practice is mandatory by religion and attenuates women’s sexual feelings, contributing to family honour. (Blanco et al., 2013, p. 2)
Very few men in this study were aware of the health consequences of FGM/C, but those who understood the harmful effects of the procedure were willing to encourage its discontinuation (Blanco et al., 2013, p. 10). This study takes an interesting look at how social norms play a role in FGM to the point where men are unaware or ignorant of the long- and short-term effects of FGM.
Education, which is another theme in the literature, has been identified as a way to eradicate the practice of FGM. Female empowerment often becomes effective when focusing on the improvement of women’s education and literacy. According to Gage (2015), education provides additional knowledge of “what is labelled as ‘modernity’. This involves new social, economic and political institutions, but also a new way of thinking. Modernity entails rationalization and reflexivity, the idea that society is malleable and that people control their own fate” (p. 11). Although this statement may be valid, other elements are needed to eliminate FGM. According to Briggs (2002), information, education, and communication (IEC) are necessary ingredients in the gradual enlightenment of a traditional society; moreover, it is important to be cognizant that a change in culture may sometimes be very slow or sometimes rapid as a result of social events or contact with other cultures (p. 51).
According to the results of a study by Sakeah et al. (2006), Somali men who did not go to school or who only finished primary school were most likely to prefer marrying circumcised women as opposed to the marital preferences of men who had attended secondary school or higher (pp. 41-42). The research also revealed that religion and ethnicity play a vital role in forming the reasons why men prefer to marry circumcised women. For example, Muslim men were more likely than Christian men to marry circumcised women (p. 45). In the results section of this study, the discussion of a number of policy implications led to suggestions for further research.
Allowing FGM participants to narrate their own experiences and comparing the narratives of subgroups can aid in forming an understanding of why there is a continuation of FGM. According to a study by Berggren et al. (2006), both genders mentioned the silent culture between the sexes as the major obstacle for change in FGM practices (p. 34). This study focused on the respective perspectives of Sudanese women and men on their experiences of female genital cutting (FGC) with emphasis on reinfibulation (RI) following delivery (p. 25). The results revealed that each gender blamed the other for the continuation of the practice; furthermore, both men and women were viewed by the researchers as victims of the consequences of FGC and RI (p. 27).
According to Lien and Schultz (2013), FGM is also a concern for female children. Yet many of the children who undergo these procedures are not very clear on what is happening or why it is happening. They may not be given time to reflect. This study used qualitative research to examine how women involved in FGM understand what has happened and why this procedure was done to them when they were younger. In-depth interviews were conducted amongst 18 women of Somali and Gambian backgrounds in Norway. These women were asked about their FGM experience. The purpose of this analysis was to learn about the knowledge that was used by these women in their meaning-making process. Two different strategies were used to ultimately achieve the same educational outcome. One strategy involved giving information, and the other strategy depended upon keeping the practice a ritual secret (Lien & Schultz, 2013, p. 170). It was revealed that while the learning process around FGM was often monitored and guided, this process stopped short of reflective thinking. As a result, most of the knowledge had been internalized and was morally embraced by the women of this study (Lien & Schultz, 2013, p. 171). Most of the analysis was conducted through the use of metaphors and narratives, and many of the stories discussed were anecdotal. Without sufficient time for critical reflection, the authors suggested that behaviour change programs aiming to end FGM should work toward:
…understanding these immigrants’ previous learning processes and the characteristics of the knowledge they may have internalized. This could in turn assist in the further development of educational programs and help facilitate and differentiate the learning process by identifying and implementing educational stimuli that can promote critical reflective thinking. (p. 173)
Studies have shown that the decision-making behind FGM contributes to the attitudes toward FGM. According to Gage (2015), decisions of FGM are not solely made by the mother, but rather by the family as a whole. Families are likely to consider the surrounding community, as FGM reflects the status of both the daughter and the family as a whole (p. 11). The study by Gage (2015) showed that a mother does not possess enough individual power in these communities to block the decisions which are made, but as a group, women do play a significant role as guardians of traditions (p. 11). Although the women in a community are usually the ones in charge of the decision-making, according to Al-Khulaidi (2013), studies have shown that men also play a vital role in the attitudes toward FGM. For example, a daughter is more likely to receive FGM when her father’s attitudes toward FGM are positive (p. 3).
Studies in the literature have also revealed that attitudes toward FGM have been upheld as a traditional rite of passage to adulthood. According to Kaplan (2016), the physical phase of the socializing process moulds the attitudes and beliefs of women, thereby preparing them to be eligible for marriage (p. 104). According to Briggs (2002), FGM has been justified by participants who felt that this ritual forms the basis for socialization into womanhood while curbing female sexual desires. This justification of FGM has also been observed by the findings of other scholars (Helm, 2014; Freymeyer & Johnson, 2007). It seems that women are rewarded for the practice with social recognition and status. Undoubtedly, one of the main factors behind the persistence of FGM is its social significance for females. In most regions where it is practiced, a woman achieves recognition mainly through marriage and childbearing – and men may refuse to marry a woman who has not been circumcised. Therefore, to be uncircumcised is to have no access to status and no voice in these communities (Briggs, 2002, p. 49). As such, FGM is perceived as a requirement for women. According to a study by Dirie and Lindmark (1991), the majority of participants related the circumcision back to their religious beliefs of being clean and pure. According to the literature, uncircumcised women are seen as non-virgins who are both unclean and impure (Johnsdotter, 2008) This view primarily stems from the religious aspects of FGM practice.
Interestingly, according to Leonard (2000), the common concepts behind FGC in relation to traditional, social, or religious norms were not identified as reasons for women wanting to undergo the procedure. Leonard (2000) indicates that the subject of FGC is at an impasse – with absolutists arguing that intervention to stop the procedure is required, and relativists asserting that outsiders have either no right or no ability to impose such change upon others (p. 162). In a study by Leonard (2000), participants were interested in and willing to put their daughters through the unsafe practicing of FGM. Fifty-two per cent of the participants had been operated on by untrained medical professionals; many had used traditional birth attendants or been operated on at home (pp. 584-585). Leonard (2000) advises that an alternative way to bring a fresh perspective to FGC is to look beyond the current discussion of FGC and past the common norms and approaches (p. 186).
As summarized by Herniund and Duncan (2006), female genital cutting (FGC) has been a topic of interest for researchers, particularly in trying to comprehend why people continue to undergo or perform FGC. Attempting to understand the behavioural changes and attitude shifts toward FGC is vital to establishing initiatives to abandon the practice. The theoretical model approach was used in a study by Herniund and Duncan (2006) to understand the behaviour change of those who changed their mind about the practice. This qualitative study collected data from Senegal and Gambia to examine how the theoretical model approach or stages of change theory could explain why FGC is practiced. The results of the findings show that individual readiness to abandon FGC is viewed as a collective change rather than an individual change due to social pressures from the community. The data showed that the concepts of the stages of change comprise a multifaceted construct that captures behaviour, motivation, and features of the environment in which the decision is being made (p. 57). The stages of change theory can be used to identify both the individual decision-maker’s readiness for change as well as the readiness for change at a community level. Further research must be employed in the form of quantitative population research.
According to Dirir et al. (2004), FGM occurs in many different regions around the world. This United Kingdom-based study attempted to examine whether there is a relationship between the age and experience of the arrived immigrants from Somalia and their attitudes toward the continued practice of FGM. The study was conducted in the greater London Area (GLA) and focused on young, single Somali women and men between the ages of 16 and 22. The study used quantitative research, and data was gathered using a cross-sectional survey based on snowball sampling of 80 males and 94 females. The results of this study showed that the abandonment of FGM was associated to living in GLA from a young age; therefore, the authors concluded that such traditions surrounding the reasoning behind FGM had been abandoned. For example, those living in Britain before the age of six were less likely to be circumcised (42%) in comparison to those who had arrived after the age of six (91%) (p. 84). However, groups who remained rigid in their thinking included older generations, males, and new arrivals who were either uninterested in adapting or who refused to adapt to the practices of their new environment. During the in-depth emotional interviews, it was revealed that there is an important connection between FGM and virginity and marriage. Participants also shared that they faced some sexual and health issues as a result of FGM. The study showed that current age and age upon arrival are factors for men who wanted to marry women who were circumcised. Of the males who had first arrived at the age of 11 and older, 50% wanted circumcised wives compared to those who had arrived at a younger age. This study revealed that 18% of female participants and 43% of male participants intended to circumcise their daughters. Females were less likely than men to agree with the common notion of sexuality and religion that underpins the practice. Many of the participants also explained that their parents’ reasons behind FGM were more traditional than their own thoughts and views.
FGM is a broad, sensitive topic that generates a wide range of discourse. Considerable research has been conducted to explore various aspects of this phenomenon. Studies in the literature explore how human behaviour and social norms are accepted through the lenses of culture and tradition and religion. FGM is a prime example of how cultures and traditions play a significant role in decision-making, attitude, and behaviour. It is vital to try and understand why FGM continues to be an accepted practice regardless of the academic and popular culture studies which have commonly reported the disadvantages and negative consequences of FGM. To this end, it is important to note that most studies have been conducted through a Western lens. The viewpoint of FGM must be studied through the African lens especially because that continent had the highest FGM rate. This approach is the most effective way to understand the ongoing practice in relation to changes in social norms.
According to Arias (2016), there are five different types of social norms: social, behavioural, personal attitude, moral, and legal. Social norms are widely held beliefs about what is typical and appropriate in a reference group. Social norms may or may not be based on accurate beliefs about the attitudes and behaviours of others (Arias, 2016). Behavioural norms are what someone actually does, whereas social norms are beliefs about what other people do and what other people think should be done (p. 11). Personal attitude norms are unlikely to direct behaviour for the majority of people in a reference group when these attitudes are contradicted by social expectations (p. 12). Moral norms, which tend to be more motivated by conscience than by social expectations, are related to deeply-held values rather than a matter of judgement or taste associated with personal attitudes (p. 12). Finally, legal norms are formal rules of the game, commanded by the state and enforced through coercion (p. 12). In order to tackle harmful social norms, interventions need to create new shared beliefs within an individual’s reference group which in turn will change expectations around behaviour (Arias, 2016).
There are implications for working with diaspora communities such as the Somali community in Toronto. For example, if some study participants wanted their daughters to undergo the procedure either illegally in Canada or by sending their daughters to Somalia, then there is no way I could stop my participants from making this choice. Furthermore, based on confidentiality contracts, I could not report any cases to social services or greater authorities. As another challenge, it is possible that when participants are revealing their stories or being interviewed, some concerns may arise or alarming information may come to light which I may be uncomfortable with; however, due to the confidentiality contract I will not be in a position to become involved.
Why should this paper be considered applied research?
This paper uncovers why female genital mutilation (FGM) is a continued practice. This investigation into a real-world problem aims to solve, eliminate, or reduce the amount of child abuse and gender-based violence inflicted through FGM in certain communities around the world. Knowledge and information are presented with the intention to not only keep the discourse of FGM going but to also educate those who are unaware of the harmful short-term and long-term emotional, physical, and psychological effects of this traditional practice. While numerous studies and advocacy initiatives have strived to eliminate this practice, research shows that FGM is still a major problem in many of these practicing communities in Africa, South Asia, Asia, and Europe. This applied research can assist with existing research surrounding FGM to find new solutions to eliminate the continued practice of FGM.
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