Chapter 71 Female Circumcision
INTRODUCTION
Description: Female circumcision is removal of part or all of the external genitalia including the labia majora, labia minora, the clitoris, or all three. Female circumcision (female genital mutilation, infibulation) is generally performed as a ritual process, often without benefit of anesthesia and frequently under unsterile conditions. The resulting scarring may preclude intromission. The amount and location of tissue removed determine the type of infibulation:
• Type II—excision of the clitoris with partial or total excision of the labia minora (most common form)
• Type III—excision of part or all of the external genitalia and stitching/narrowing of the vaginal opening (infibulation)
Other forms of female genital mutilation include the following:
• Scraping of the tissue surrounding the vaginal orifice (angurya cuts) or cutting of the vagina (gishiri cuts)
• Introduction of corrosive substances or herbs into the vagina to cause bleeding or for the purpose of tightening or narrowing it
Prevalence: Approximately 168,000 women in the United States, approximately 96% of women in some African countries (e.g., Somalia). (Amnesty International estimates that it is performed on more than 130 million women worldwide.)
ETIOLOGY AND PATHOGENESIS
Causes: Performed as part of ritual or religious beliefs, generally without the permission and often without the cooperation of the young girl herself.
CLINICAL CHARACTERISTICS
Signs and Symptoms
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