HealthRight Supports International Day of Zero Tolerance to Female Genital Mutilation

Miriam* was seven years old when a group of women came to her home in Somalia, where some 98% of women are subjected to Female Genital Cutting (FGC), sometimes referred to as female circumcision or Female Genital Mutilation (FGM). She did not know why they were there or what was about to happen. The women removed her clothes, held her tightly by her shoulders and knees and began to cut away at her between her legs using scissors and a knife, as she cried and struggled to close them.  When the women were done cutting, they sewed her torn flesh together and bound her legs together. She remembers a lot of blood and terrible pain. After the procedure, she felt deep shame and sadness. Later, as an adult, she felt great fear and anxiety before her wedding night. Her fear was validated with the great pain she feels during intercourse. She has also had terrible difficulties when giving birth. Following the birth of each of her four children in Somalia, Miriam was reinfibulated.

Fearing that her daughters would have to endure the procedure and its devastating consequences, Miriam fled Somalia and asked for asylum as she entered the United States. Miriam was put in an immigration detention center where she awaited the resolution of her asylum claim for months. Though in detention, she was able to secure a pro bono attorney through a nonprofit organization, who worked with HealthRight International’s Human Rights Clinic (HRC) to arrange a forensic medical exam for Miriam. Miriam was allowed by Immigration and Customs Enforcement to be transported to the office of an HRC volunteer physician, who documented her FGC and other signs of abuse. Luckily, Miriam was recently granted asylum. If she were returned to Somalia, Miriam fears she would not be able to protect her daughters from the deeply entrenched traditional practice.

Standing Up Against FGC

Daniel* first encountered FGC when he was ten years old. A group of women from his village in Sierra Leone came to his house and took away his sisters, who screamed and cried as they were dragged from under their beds. When his sisters returned, he instinctively knew that something awful had happened to them. When he eventually learned what had happened, Daniel said, “I immediately made my resolution to stand against FGM.”  His willingness to speak up against the practice earned him numerous threats. When Daniel became a father, he refused his community’s demands to allow his daughters to undergo FGC. One day, he was followed home by a group of angry villagers who severely beat him and left him unconscious in the road. Daniel fled Sierra Leone and is seeking asylum in the United States. He received medical and psychological evaluations by HRC volunteer clinicians in New York City to help document the lasting physical and psychological effects of the torture he endured. Despite his experience and its permanent effects, Daniel is determined to continue supporting efforts to prevent FGC, which continues to be performed on 90% of girls in Sierra Leone. 

What is Female Genital Cutting/Mutilation?

The terms female genital cutting (FGC), female circumcision, and female genital mutilation (FGM) describe the cultural practice of partially or totally removing the external female genitalia. According to the World Health Organization (WHO), FGM is any procedure that alters the female genitalia for non-medical purposes. It is practiced by certain cultures in Africa, Asia and the Middle East and among some ethnic communities in North America and Europe. It is usually performed on girls between infancy and adolescence. Sometimes, it is performed on adult women as well. The WHO describes four types of FGC:

Type I: Clitoridectomy involves partial or total removal of the clitoris and/or the pupice.

Type II: Excision is the removal of the labia minora, with or without excision of the labia majora and clitoris.

Type III: Infibulation excises, repositions and fuses the labia together, leaving only a small opening for urine and menstrual fluids.

Type IV: Other includes any other mutilation of female genitalia, such as pricking, piercing, incising, scraping or cauterizing.

How is FGC performed?

In some cultures and socioeconomic groups, FGC is performed by health care providers in medical facilities.  The vast majority of procedures are performed by women in the community in non-sterile environments using diverse instruments such as knives, broken glass, or even the woman’s fingernail. The instrument is often reused to perform several FGC procedures at once. Frequently, there is no anesthetic or pain medication, so a young girl may be held down or sat upon by several other women while she is cut. 

Why is FGC practiced?

Cultures practice FGC for varied reasons.  Some consider FGC to be the proper way to raise a girl to prepare her for adulthood and marriage.  Some consider FGC a rite of passage.  Others employ FGC to control a woman’s sexuality and to ensure her virginity before marriage and, later, fidelity to her husband. Some believe that intact genitals are unclean or unattractive. Some societies perpetuate the practice simply for the sake of tradition. 

What health effects does FGC have on women?

Long-term consequences of FGC can include recurrent bladder and urinary tract infection, cysts and abscesses, infertility, risk of childbirth complications (including obstetric fistulas), dyspareunia (painful sexual intercourse), and sexual dysfunction.  The procedure may result in severe pain, shock, hemorrhage, tetanus, sepsis or death. Women who have undergone FGC also frequently report adverse psychological consequences including feelings of incompleteness, anxiety, depression and Post Traumatic Stress Disorder (PTSD).  

How does the Human Rights Clinic help women who have undergone, or fear being forced to undergo, FGC?

HRC volunteer clinicians provide expert examination and written documentation of the physical and psychological consequences of FGC on HRC clients and provide expert testimony in their asylum hearings. In some cases HRC volunteers provide documentation for women and girls who are fleeing their countries to avoid FGC to confirm that their genitalia have not been mutilated. 

HRC’s Access to Support and Services for Survivors of Torture (ASSIST) program connects clients who have been subjected to FGC to medical, mental health and other social services in their communities that can help them address the ongoing effects of FGC, as well as the stresses of migration.

How can you help?

If you are a licensed physician or mental health professional you can be a volunteer clinician with the HRC to provide physical and psychological evaluations of survivors of torture, FGC, and other forms of abuse and provide written testimony for their immigration cases.  Visit our website to learn more about volunteering with the HRC:  

Even if you are not a doctor or mental health professional, you can still help women who have undergone or are at risk of FGC by supporting the Human Rights Clinic. To make a gift, visit us at:    

The stories of these brave individuals remind us of the importance of International Day of Zero Tolerance for Female Genital Mutilation. For more information on HealthRight’s services for survivors of FGM/FGC, click here.

If you are an attorney representing a survivor seeking asylum and you’d like to request a forensic evaluation, you can find more information here:

To donate to the HRC, click here and indicate “HRC” in the notes section.