The evolving practice of FGM/C in Sudan: A brief historical overview
The emerging nation of Sudan is situated in north-east Africa. Compared to other African nations, it is a sizeable but sparsely populated nation – the third largest country in Africa with a population of over forty-one million. With approximately twenty-one million youngsters under the age of eighteen and 6.5 million children under the age of five, the nation is full of youth.
1 UNICEF (2022). ‘Children in Sudan’, https://www.unicef.org/sudan/children-sudan [Accessed 16 October 2025]. Sudan is also diverse, socially, culturally, and ethnically.
UNICEF, in partnership with various NGOs, has taken a strong stance in addressing the issue of FGM/C in Sudan for over fifty years. Although the overall prevalence remains high, this is not the full story. There have been notable shifts in the nature of the practice itself, shifts that reflect both changing perceptions and evolving social dynamics.
The shift in FGM/C practices: From Type 3 to Type 1
One of the most significant changes in Sudan’s FGM/C landscape is the shift in the type of cutting performed. In recent decades there has been a noticeable shift toward Type 1, commonly known as the sunnah cut. This is less invasive than Type 3, involving the removal of the clitoral hood or a portion of the clitoris, with the aim of fulfilling a perceived religious or cultural obligation rather than controlling sexual desire as in the case of Type 3 (Gibeau 1998:27). This shift reflects, in part, the influence of anti-FGM/C campaigns, particularly those focusing on the health risks associated with more severe forms of cutting. It is believed that the change in practice is driven by the hope that less severe forms of FGM/C, such as the sunnah cut, would mitigate the associated health risks, while still adhering to the cultural or religious norms that perpetuate the practice (Kimani and Shell-Duncan 2018; also see Thomson and Callaghan, Chapter 4 in this volume, on religion and FGM/C).
Age of FGM/C: A move toward later interventions
Another significant change in the practice of FGM/C in Sudan is the higher age at which girls undergo the procedure. Historically, many girls were subjected to FGM/C at very young ages, some as young as four years old. However, data from the most recent (2014) Multiple Indicator Cluster Survey (MICS) reveals a gradual shift, with more girls undergoing FGM/C at older ages. Between the 1980s and early 2000s, the proportion of women aged fifteen to forty-nine who reported undergoing the procedure at age ten or older more than doubled, from 10 per cent to 23 per cent (Thiam 2016). Furthermore, the number of women who underwent FGM/C before the age of five decreased by nearly two-thirds between 1989 and 2014, from 13 per cent to just 5 per cent (ibid.).
These changes may also be linked to growing awareness of the physical and emotional toll of early childhood circumcision. As the harms of early FGM/C become more widely recognised, communities may be opting to delay the procedure in hopes of reducing immediate health risks, such as excessive bleeding, infection, and shock, which are more prevalent in younger children.
The rise of medicalisation: Health professionals and the institutionalisation of FGM/C
A concerning trend in Sudan’s FGM/C practice is the increasing involvement of health professionals in performing the procedure, a phenomenon known as medicalisation (see the Introduction and Afterword, this volume). Traditionally, FGM/C was carried out by traditional circumcisers – often elderly women in the community who had done this for generations. However, that is changing. According to the 2014 MICS data, more than half of girls aged ten to fourteen were circumcised by a trained health professional. The proportion of FGM/C procedures carried out by medical personnel has steadily increased over time, with midwives performing 72 per cent of cases between 1990 and 1999, rising to 80 per cent between 2000 and 2014 (Thiam 2016).
The medicalisation of FGM/C is often presented as a way to make the procedure ‘safer’, with proponents arguing that it can be done in a more hygienic and less damaging manner. But the involvement of trained medical personnel raises ethical concerns and questions about the role of medical institutions in perpetuating harmful practices. By medicalising FGM/C, the procedure may gain a veneer of legitimacy, making it harder to challenge. The increasing role of health professionals also reflects the broader issue of institutionalised complicity in harmful cultural practices.
Understanding the drivers of change
While these shifts in the practice of FGM/C in Sudan are noteworthy, the underlying drivers of change are not fully understood. There are many factors at play – cultural, social, religious, and economic – that influence how and why FGM/C is practised, and why it is changing in particular ways. To better understand the drivers of change, it is essential to explore the role of both local and national factors, including:
Community and religious beliefs: The enduring cultural and religious justifications for FGM/C remain strong in many communities, despite growing knowledge of its harms. FGM/C is often viewed as a rite of passage, a way to control female sexuality, and an important marker of social identity. In some communities, it is closely tied to religious beliefs, with the sunnah cut (Type 1) being seen as part of Islamic tradition, despite there being no religious mandate for FGM/C in Islam (Chapter 4, this volume).
Health and medical discourse: The framing of FGM/C as a health issue, particularly by international health organisations, has undoubtedly influenced the way people think about the practice. Campaigns that highlight the risks of more severe forms of FGM/C may have encouraged the shift from Type 3 to Type 1, as communities seek to mitigate the risks while maintaining the practice. Similarly, the rise of medicalisation reflects the increasing integration of health discourse into the practice, as medical professionals are seen as ‘legitimate’ figures who can carry out the procedure more safely (UNICEF 2016).
Education and awareness campaigns
While public awareness campaigns have made significant strides in educating people about the dangers of FGM/C, their effectiveness remains debatable. In some areas, the information provided has led to a reduction in the practice, while in others, entrenched social norms and fears of social ostracism continue to drive it, albeit in a less severe form.
The Saleema Initiative, launched in 2008 by the National Council for Child Welfare and UNICEF Sudan, focuses on protecting girls from FGM/C by promoting collective abandonment at the community level. The name ‘Saleema’ symbolises a state of being whole, healthy, and untouched – natural, unaltered, and in a God-given condition. Its primary objective is to shift societal attitudes toward FGM/C, encouraging the use of positive terminology that celebrates the natural bodies of girls and women. Since its inception, Saleema has spread across Sudan and sparked interest in neighbouring countries like Somalia and Egypt (Evans et al. 2019). The programme is grounded in social norms theory, which posits that FGM/C persists due to deeply ingrained social beliefs about what behaviour is expected in a particular community. The Saleema Initiative works to change these beliefs by creating alternative narratives that emphasise the social acceptability of uncut girls. Over time, it is hoped that this shift in perceptions will result in the abandonment of FGM/C.
In 2014, the initiative was evaluated to assess its impact on social norms, behaviours, and attitudes toward FGM/C. This focused on tracking changes over time, the degree of exposure to Saleema across different regions, and the role of Saleema’s social marketing strategies in influencing change. Key goals included measuring social norms about FGM/C, determining if higher exposure to Saleema led to improved beliefs about FGM/C abandonment, and examining the effectiveness of branding in promoting change. Through these efforts, Saleema aims to redefine social expectations and contribute to a broader cultural shift toward protecting girls from FGM/C (Evans et al. 2019).
Legal and policy frameworks
The role of laws and policies in combating FGM/C is another critical factor (see Njenga, Chapter 11, this volume, for a pan-African perspective). Although Sudan has ratified international conventions that call for its abolition, national laws prohibiting the practice have been weakly enforced (UNICEF 2016). In July 2020, Sudan took a significant step toward combating FGM/C by implementing a national law prohibiting it. Law No. 12 of 2020 amended the Criminal Act (1991) and marked a pivotal moment in Sudan’s legal and social history. At the heart of the reform was Article 141A, which criminalised FGM/C for the first time in Sudan’s history. This amendment was not just a legal technicality but a powerful statement against the practice, signalling a shift in Sudan’s approach to human rights and gender equality. The passage of Law No. 12 was not only supportive of women’s rights in Sudan but also a reflection of the country’s broader political and legal changes.
With the overthrow of the former regime in 2019, Sudan underwent a period of significant reform, during which many laws that were seen as discriminatory or repressive were reviewed and amended. The criminalisation of FGM/C represented a direct challenge to harmful traditions and a call for social change. However, while the national law made FGM/C illegal across Sudan, it was not immediately effective in all areas. Prior to 2020, six states had already enacted legislation to curb the practice within their borders. These states included Gedaref, South Darfur, South Kordofan, and Red Sea. The implementation of these laws faces significant challenges, including difficulties in prosecuting offenders and a lack of clear data regarding prosecutions (UNICEF 2020).
The 2020 national law sought to address this patchwork of regional regulations by providing a uniform legal framework, making FGM/C illegal nationwide. In this way, it was hoped that Sudan could ensure greater consistency in its efforts to protect girls and women while also shifting public attitudes toward the practice. With the criminalisation of FGM/C, Sudan took a crucial step toward fulfilling its obligations under international human rights agreements and advancing the cause of gender equality.