Introduction
Lotte Hughes, Mark Lamont, Katy Newell-Jones, and Damaris Parsitau
The issue of female genital mutilation/cutting (FGM/C) has become a cause célèbre in recent decades, both within regions of the world where FGM/C is practised, and globally. While it is primarily practised in Africa, the Middle East, and Asia, it is also practised in Western countries in some immigrant communities, and girls are sometimes sent briefly back to Africa to undergo FGM/C. Global migration has made it an international phenomenon. This is why, in a book on African issues, we also include discussion of FGM/C in the diaspora.
At least 230 million women and girls alive today have undergone FGM/C.
1 WHO 2025: https://www.who.int/news-room/fact-sheets/detail/fem ale-genital-mutilation [Accessed 16 August 2025]. It is known to reduce the life chances of substantial numbers of girls and women, and to cause significant harm and sometimes death. While FGM/C sparks public outrage and shock among a wide range of actors, with zero tolerance levied towards these practices and even attempts to rationalise or explain them, some take the position of cultural relativism (see the textboxes on zero tolerance, p. 204, and cultural relativism, p. 281). An example of this is anthropologist Richard Shweder, who calls this public ‘disgust and anxiety’ over FGM/C a ‘mutual yuck response’ (Shweder 2000:216).
Blanket condemnation of FGM/C is not helpful; some would argue that it is counterproductive. To understand why people continue practising FGM/C, and find ways of ending or reducing it, one must first understand what it means to those who practise it. Furthermore, one must also understand what it means in the context of different ethnic communities. With so much emphasis placed on the physical cut in anti-FGM/C campaigns and interventions, deeper nuanced socio-historical-ethnographic contextualisation can sometimes be lost. We are more concerned in this volume with examining the social relations in which FGM/C is embedded, and the discourses around the practice and campaigns against it. Overall, we take a holistic approach to FGM/C that includes many different viewpoints, not least those of community members. Where possible, their voices will be featured. Some readers may find some of our authors’ views controversial. As editors we are aware of the likelihood of generating controversy (see ‘Axes of Difference’, towards the end of this Introduction, which identifies and discusses some of the main areas of contention). Controversy, though challenging, can be used to create an important space for open dialogue and the respectful exchange of views, which is what we intend here.
We do not discuss the origins of FGM/C; this has been speculated upon by many other authors (e.g. Boyle 2005; Gruenbaum and Ahmed 2022; Lightfoot-Klein 1989; Mackie 1996; Shell-Duncan and Hernlund 2000). Suffice to say there is some evidence that points to female genital cutting having been practised in ancient Egypt as long ago as the second century BC, and that it spread from there to Sudan, where the term pharaonic circumcision refers to its pharaonic historical legacy (Boddy 1989:51; Gruenbaum and Ahmed 2022).
Terminology
Before we discuss the issue and wider debates, it is necessary to explain the debate about terminology and the contentiousness that surrounds it (e.g. see Boyle 2005; Gruenbaum 2001; Shell-Duncan and Hernlund 2000; Abusharaf 2006 on terms for FGM/C in local African languages). Several terms are used to describe the practice of altering female genitalia. Most commonly used are female circumcision (FC), female genital mutilation (FGM), female genital cutting (FGC), and the hybrid term FGM/C. ‘The cut’ and ‘cutting’ are often used colloquially. Some scholars (including some contributors to this book) prefer ‘female genital modification’ (FGMo). Those using the term FGM, i.e. labelling all FGM/C as mutilation, argue that it is important to be uncompromising in one’s opposition to a practice that causes considerable physical and mental harm to large numbers of girls and women, affecting their life chances and quality of life.
2 Scholars are not agreed on who first coined the term. David Anderson writes that it was medical missionary Dr John Arthur of the Church of Scotland who first appears to have used the word ‘mutilation’ to describe clitoridectomy in colonial Kenya (2018:10). These missionaries would have examined genital cutting through a biblical lens, in particular the ways in which male circumcision became a divisive issue in the early church. The New Testament word peritomē (Greek) meant ‘circumcision’, but in Philippians 3:2 Paul contemptuously called those urging Gentiles to be cut as belonging to the katatomē, which the King James Bible translates as ‘concision’, meaning a destructive slicing. Later bible translations render ‘concision’ as ‘mutilation’. Those using the term FGC tend to argue that the word ‘cutting’ more accurately reflects changes in the type of cut undergone by many young girls, is less judgmental, consequently leads to greater dialogue in practising communities, and hence opens the space for movement towards abandonment. In communities in transition from infibulation (see the WHO’s classification of types, textbox p. 24) to other forms of cutting, the term FGM is sometimes seen as referring only to the most invasive forms. In this book the editors have chosen to use the hybrid term FGM/C, while recognising its limitations. Individual chapter authors have used their preferred terms, hence the range of terms used across this book. (For more on terminology, see ‘Axes of Difference’ towards the end of this Introduction.)
The World Health Organization (WHO) uses the term FGM and defines it in this way:
Female genital mutilation (FGM) comprises all procedures that involve partial or total removal of the external female genitalia, or other injury to the female genital organs for non-medical reasons. The practice has no health benefits for girls and women and can result in severe bleeding and problems urinating, and later cysts, menstrual difficulties, infections, as well as complications in childbirth and increased risk of newborn deaths.
3 WHO Factsheet (see note 1), 31 January 2025.The WHO goes on:
The practice of FGM is recognized internationally as a violation of the human rights of girls and women. It reflects deep-rooted inequality between the sexes and constitutes an extreme form of discrimination against girls and women. It is nearly always carried out on minors and is a violation of the rights of children. The practice also violates a person’s rights to health, security and physical integrity; the right to be free from torture and cruel, inhuman or degrading treatment; and the right to life, in instances when the procedure results in death.
The WHO has classified four major types of FGM (see textbox on p. 24), which it then further divides, reflecting the wide variation in the practice (WHO 2025).
The overwhelming majority of those who perform FGM/C have received no medical training in the practice. Traditional birth attendants (TBAs) and other traditional cutters have learnt from other cutters in the community, who in turn had the role passed down to them. Health workers, nurses, and midwives who perform FGM/C will usually have training in aseptic techniques, pain management, and infection control, but not in the actual clinical procedure of FGM/C. In Somaliland, Newell-Jones (2016) encountered calls from community midwives and TBAs for training in how to carry out FGM/C, as well as calls for FGM/C to be included in the midwifery curriculum, from senior figures including staff in the Ministry of Religious Affairs. Both these measures would normalise medicalised FGM/C.
The twenty-two African countries that had, by 2018, introduced legislation banning FGM/C do not, in all cases, outlaw all types. Four of these (Cameroon, Ethiopia, Nigeria, and Tanzania) do not include ‘any real definition of FGM in their current legislation’ (28 Too Many 2018:34). UNICEF points out that many girls and women are unaware of the type of FGM/C they have undergone, and ways of classifying it in communities often differ from the WHO classifications (2013:7). There is increasing evidence that non-cutting or ‘less severe’ alternatives are being developed by individual families and communities that have modified their practices over time (Crawford and Ali 2015; Newell-Jones 2016, 2017; Van Bavel 2021).
Variations in terminology and practice
FGM/C is complex, and the WHO types do not necessarily cover every variation performed. The WHO refers to the ‘ambiguity of language in relation to FGM’, recognising that the same term can refer to multiple types of cut, and the use of ‘euphemisms or other coded ways of referring to FGM’ (WHO 2021). Obermeyer (1999:84) has written about ‘the incomplete correspondence between biomedical categories and local terminology’, and stresses that the term FGM/C ‘poses a thorny issue in the local languages’ of practising communities. Other scholars have made similar points (e.g. Bjälkander et al. 2013; Boyle 2005; Crawford and Ali 2015; Elmusharaf et al. 2006; Gruenbaum 2001; Newell-Jones 2017). Opposition to FGM/C has tended to centre upon the most ‘extreme forms’, notably infibulation, which has come to represent FGM/C in popular discourse. Yet globally, infibulation only constitutes 10 per cent of FGM/C (Earp 2015, citing Ahmadu 2000), although in some countries, for example Somalia, it remains the most practised form. Gruenbaum, Earp, and Shweder (2023: 202–3) note that media and policy often highlight extreme cases of female practices while downplaying male practices such as medicalised neonatal circumcision in the United States. This leads to inaccurate generalisations and stereotypes about culturally diverse communities engaging in these practices.
The international movement against FGM/C
The international movement for the eradication of FGM/C has gained increasing momentum in recent decades, led by bodies including the WHO and United Nations agencies UNFPA and UNICEF, whose Joint Programme on the Elimination of FGM began in 2008 and currently operates in seventeen countries, all apart from Yemen in Africa.
4 UNICEF: https://www.unicef.org/protection/unfpa-unicef-joint-progr amme-eliminating-fgm [Accessed 4 August 2025]. Last modified March 2025. The WHO initially avoided studying or working on FGM/C, ‘claiming the practice was outside the organisation’s competence because it was of a “social and cultural rather than a medical nature”’ (Boyle 2005:41). There was ‘a widespread view … that the practice fell outside the jurisdiction of the international system’ altogether (ibid.:45). That position was to radically change. Shell-Duncan and Hernlund (2020:1) note that the ‘current resurgence of indignation’ about the practice can be traced to a series of conferences that celebrated the UN Decade of Women (1975–88). (See Chapter 1 for an account of these conferences, and the resulting resolutions and protocols. Chapter 2 also discusses these landmark resolutions and events, but takes a different approach analytically.)