Index

ActionAid International Somaliland (NGO) 101

Empowering Communities to Collectively Abandon FGM/C 101

Activism, activists, and campaigns against FGM/C (also see individual NGOs and countries) 8 (diaspora), 48, 176, 198, 208, 209, 228

activism in UK 160 (also see much of Chapter 8)

activists 8, 17, 22, 27, 35, 40, 41, 53, 83, 94, 160, 161, 175, 176, 190, 198, 201, 213, 233, 284, 292, 293

by mothers and MPs around boys’ circumcision (Kenya) 61, 62, 65, 68, 69, 73

campaigns (global) 1 (see Chapters 1 and 2 passim)

changes in campaigns and discourses over time (see Chapters 1 and 2 passim)

cultural rights activism 271

traditionalists’ (African) challenges to anti-FGM/C 233

Africa (also see individual countries, research, cross-border FGM/C, colonialism, neo-colonialism, neo-imperialism)

African agency (in and outside Africa) 153

anti-FGM/C laws­ (see Chapters 1 and 11 passim, also legislation entry) 207–8

defiance of 73, 51, 59, 120, 145, 207, 213, 215, 235, 237, 239, 240, 252, 254, 255, 269, 270, 254 (also see UK, and other resistance sub-entries)

prevalence of FGM/C 38, 40 (also see individual countries)

and colonial legacies 15, 63, 188, 191, 192, 224, 270, 295

and Inter-African Committee on Traditional Practices (IAC) 30, 45, 176, 177 n.10, 212, 284

African Charter on Human and Peoples’ Rights (Banjul Charter. Adopted 1981, entered into force 1986) 30–1, 50, 209

African Charter on the Rights and Welfare of the Child (1990) 30, 209

African Union (also see Maputo Protocol) 30, 32, 34, 50, 90, 209

Agendas (global, anti-FGM/C) 27–8

development agendas 289 (and see individual NGOs and agencies)

donor driven 112

how they changed over time (see Chapters 1 and 2 passim)

implementation (of laws, policies, etc.) 35, 40, 139, 156 (UK), 205, 207, 210, 213 (see Chapter 1, and Chapter 11 passim on legislation)

problems with reform agendas 285–7

shift in focus from health to human rights 27, 28, 50, 54, 57, 191

Age-sets

Maasai 276–8

and women 272, 275, 277

Ahmadu, Fuambai 293

Alternative Rites of Passage (ARP) (also see CLARP, Amref Health Africa, Chapters 13 and 14 passim) 7, 12, 14, 233–4, 243, 245, 265–8

aims of 12, 14, 243

ceremonies (graduation of initiates) 234, 250–1, 267, 272, 277, 278

community acceptance (claims of) 273

community ownership (or lack of) 234

critiques of 225 (see Chapter 14 passim)

culture

ARP as cultural performance 233, 272

difference between culture and behaviour 268–9, 272

uses of culture in ARP 265–80

educational elements 233, 271 n.10

financial incentives for adult participants 273

girls’ repeat participation 273–4

history of 233, 273 n.15

Maasai women’s views of 278

reliance on external funding 233

ritual transformation (function of) 274–6, 279

traditional initiation (mimicry of) 274–6

and assessment of earliest ARPs by the Population Council 247–8

and public declarations 267 n.6, 274

and social norms 265–6

and Louis Leakey (1930s Kenya) 268, 268 n.8, 279

American Bar Association (ABA) 216, 218, 231, 236, 237

Amref Health Africa (NGO) 270 n.9, 273, 274, 286 (see Chapter 13 passim) and CLARP (Community-Led Alternative Rites of Passage). Much of the following is about CLARP

challenges (and how they were managed) 252, 254–5, 259–61

critiques of 248, 259–64

community movement (towards abandonment) 249, 251, 253

community power structures 252

data analysis 245

design and development of 245, 248–54

dialogues (cross-community and gender) 249, 252, 254, 255

education (and training) 250, 249–50, 256, 261

engagement with

boys and men 249–50, 251, 252, 254, 255, 256, 257, 264

communities 259–50, 251, 254, 264 (and Chapter 13 passim)

CSOs 250

evidence gathering 258–9

formula 249

funding challenges 263–4

girls

early/child marriage 247, 248

school drop-out 247, 248

social pressure on 37, 95, 258, 260–1

teenage pregnancy 247, 248, 251, 259

Tracking the Girls (mobile app) 251, 258–9, 260

goals of CLARP 251

lessons learned 252

limitations of 248, 255

methodology 245, 257–8, 260, 262–3

resistance (by communities) 254–5

stakeholders 246–7, 249

weaknesses of 264

sustainability 260

fathers, warriors, elders (role of) 250, 251, 254

medicalisation 252

role of medical practitioners in FGM/C 252

Pan-African FGM/C Vision 253

research studies 259

Sexual and Reproductive Health and Rights (SRHR) 248–9, 250, 251

shift to a human rights approach 252

TBAs/traditional cutters 247, 249, 250, 252, 254

theory of change 251, 251 n.6, 257

women 246, 247, 248, and Chapter 13 passim

and Maasai 246–7, 252 (and Chapters 13 and 14 passim)

reasons for and against practising FGM/C 247

and Nice Leng’ete 251

Anti-FGM Board (Kenya) 215, 246, 246 n.1, 271 n.10

and campaigner Agnes Pareyio 271 n.11

and Alternative Rite of Passage Guidelines 266 n.3

Anthropology 43, 44, 52, 53–4, 58, 59, 271 (and see much of Chapter 2)

as a field or discipline 55

feminist anthropology 55, 52

intellectual traditions 54

internal tensions in the field of 53–4

intersection with feminism 53

women’s 44, 52

and anthropologists 52, 53–4, 58, 62, 271, 281

and feminism 53, 59

Asia 33, 37 n.16, 282

prevalence data 38, 40

Axes of Difference 7, 17–22

Bamako Declaration 176, 177 n.10

Barbarism (as a trope) 7, 156, 268, 270, 284

‘barbaric’ practices 151, 156, 270, 284

FGM/C seen as barbaric practice brought to UK by Africans 170

Barrios de Changara, Domitila 45

Beijing Declaration and Platform for Action (1995) 32

Behaviour (also see social norms)

behaviour change 13, 20, 98, 34, 51, 108, 133, 248 (see Chapter 7 passim)

drivers of 98 (see Chapter 7 passim)

models of 140 (ditto)

theories (ditto)

behavioural norms 265, 266 n.2

offending behaviour (UK) 153

and culture 268–9, 272

and influence of religion/religious leaders (see Chapter 4 passim)

Benin 85, 86, 87, 89, 177

Bible (also see Christianity, religion, religious/faith leaders) 79

biblical references to male circumcision 3 n.2

biblical translation of ‘mutilation’ 3 n.2

Bioethics (also see bodies, bodily integrity, bodily autonomy) 10–11, 17, 191, 194

autonomy 95 (individual), 235 (girls); for women, see women entry

and male ideals of 68

bioethicists 10, 11, 62, 95

cultural relativism 95

informed consent 57, 95, 104, 293, 295

medicalisation 95

textbox 95

and harm reduction strategies 95

and Public Advisory Network on Female Genital Surgeries in Africa 95

Bodies (also see bioethics) 6, 8, 19, 20, 29, 42, 47, 52, 59, 75, 138, 157

African women’s bodies as a ‘colonial battleground’ 8

bodily autonomy 57, 95, 191, 194, 195, 196, 197, 202, 221, 232

bodily integrity 19, 28, 43, 50, 60, 61, 66, 67, 74, 90, 95, 229, 230, 243

the new politics of 72

bodily modification 52, 57

legitimising women’s bodies 52, 50

regulating men’s bodies (Kenya) 71

views of Black Muslim female bodies (in UK) 170

and historical views of African women and girls 8

Boddy, Janice 16, 189

Bondo (Sierra Leone) 12, 284, 292, 293

Boys (also see men, male circumcision. For latter see Chapter 3 passim)

agency of 250

empowerment of 256

engagement with 6, 12, 100, 114, 122, 124, 125, 249, 250, 251, 256. 257, 266, 285, 286, 290

rights of 68

violence against 25, 65

violence legitimated 66

vulnerability of 68

and hazing 63, 63 n.3, 67

Bristol research on Somali heritage communities in UK (also see UK, e.g. for a list of UK government departments mentioned in the studies, and Chapter 8 passim)

activism/campaigning by affected groups 160

Bristol Model 160, 163

and Integrate (youth charity) 160

Bristol Safeguarding Children Board 160, 163

and safeguarding boards generally 163

Caafi Health (research partner) 161

context of 160–2

criminalisation of African diaspora communities 155, 156, 166, 169

criticism of government approach and policy 169 (and Chapter 8 passim)

data (unreliability of) 158–9, 170

and guesstimate of girls ‘at risk’ 158, 169

epidemic of ‘hidden crime’ 155, 164, 169

ethical approach to knowledge co-production 161–2

exaggerated risks to girls and women 159–60

FGM Protection Orders 155 n.1, 156 n.2, 157

FGM safeguarding 153, 155 n.1, 156, 161, 162, 163, 164, 165, 166, 167, 168, 169, 170

healthcare services 68, 164, 167, 168

neglect of healthcare needs 156, 168, 170

people’s trust in undermined 167–8, 170

hypervigilance of safeguarding 153, 170

internalised hypervigilance 165

inconsistent approach to ‘FGM’ and FCGS 157, 158, 169

medical and social work professionals 159 n.3 and 4, 162, 164, 168

methodology (research) 161

migrant (Somali heritage) families 163, 165, 166, Chapter 8 passim

attitude change (towards FGM/C after immigration) 158

British identity questioned 166

criminalisation of 153

discrimination against 153

parents treated as potential offenders 163

racism and racial profiling 156, 161, 166, 168

sense of ‘unbelonging’ 166

Somali Parents Against Stigmatisation 161

stigmatisation of diaspora communities 156, 162, 164

traumatisation/retraumatisation (see trauma entry)

and (incorrect) risk assessments 162

and views of African diasporic cultures 156, 170

schools and teachers 162, 165

school referrals 163

Britain (see UK, Bristol research, and Chapter 8 passim)

Burkina Faso 50, 85, 86, 87, 88, 177, 188, 174, 217

decline in prevalence 217

Bridewealth (and links to FGM/C) 49, 64, 246

Campaigns/campaigning (see activism, individual NGOs and agencies)

Cameroon 4, 85, 6, 87, 89

Candlelight (NGO) 108, 108 n.4

Care International (NGO) 90

CEDAW (Convention on the Elimination of All Forms of Discrimination Against Women) 30, 40, 49, 50, 51, 208, 209

General Recommendation No. 14 (1990) 31, 40, 50, 208, 209, 216, 216 n.12

General Recommendation No. 19 (1992) 31, 40, 50

General Recommendation No. 31 (2019) (Jointly with the CRC) 50

criticism of 51

Central African Republic

anti-FGM/C law (1966) 208

Ceremonies (also see ritual, rites of passage, Alternative Rites of Passage) 52, 55, 56, 60, 234, 243, 247, 252, 254, 255, 266, 267, 267 n. 4, 274, 275, 276, 278, 279

Chad 16, 85, 86, 87, 89

Change (also see behaviour change, prevalence in specific countries) 77, 94, 97–8, 117

barriers to 100

change champions 251

community based 20, 29, 97, 102, 108, 110

community driven 97

cultural 7, 17, 56

drivers of 94, 98, 133, 135, 137, 139, 140

FGM/C believed impervious to 56

measuring change in

attitudes and behaviour 39, 264

cross-border FGM/C 241

prevalence 19, 29, 34, 37–8, 291

models of change 139–40

norms change 13, 20, 56

participatory 20, 97, 100, 111

resistance to change/laws 13, 37, 112, 218, 224, 232, 233, 236, 237, 239, 240

stepwise 204

theories of 20, 98, 133 (also see Chapter 7 passim)

and change agents 9, 12, 102, 115, 116

in types of FGM/C performed 19, 105 (also see Chapters 5, 7, Afterword)

Childbirth (also see Traditional Birth Attendants, TBAs) 3, 9, 11, 105 n. 2, 107, 227 n. 4, 130, 134, 158, 184, 250, 277, 284

traditional birth practices 49

Children (also see boys, girls) 31, 45, 85, 128, 135, 136, 153

child, early, and forced marriage 14 n.7, 34, 49, 79, 124, 125 n.3, 126, 127, 128, 175, 178, 235, 247, 251, 252 n. 5, 258, 262

child protection 30, 31, 36, 104, 251 (see Chapter 8 for UK ‘FGM safeguarding’)

children’s rights 67, 222, 283 (also see violence entry)

legal protection for minors 182, 195, 197, 208, 210 n. 4

and consent 153

Clitoris 24, 99, 135, 172, 173, 174, 175, 178, 183, 184, 185, 186, 188, 192, 194

aesthetics of 178

clitoroplasty 188–9

cutting equated with women’s subordination 194

‘fate’ of excised organ 179, 179 n.14

length of 178, 179

seen as ‘excessive’ or too large 189, 199

symbolic pricking of clitoral hood 190, 192, 194

symbolism of in Western discourse 194

and clitoris positive movement 186

and research by Gillian Einstein 173

Clitoridectomy (see female circumcision and other terms for FGM/C, reverse clitoridectomy, Pierre Foldes, Dr O’Dey) 3 n.2, 8, 16, 134, 174, 185

Christianity (also see missionaries, bible, faith, faith leaders, faith groups, different denominations)

and bible translations 3 n.2

Churches (also see Christianity, faith, religion) 3 n.2, 16, 70, 277

Catholic 84

Coptic Orthodox Church 78

Pentecostal 84

Circumcisers (aka cutters) 122, 156

female (aka Traditional Birth Attendants, TBAs) 122, 136, 196, 228, 229, 233, 241, 249, 252, 254, 292

and alternative incomes 12, 100, 254

male 64, 70

Civil society organisations (CSOs) 22, 34, 97, 99, 100, 101, 106, 108, 109, 110, 111, 113, 114, 116, 215, 249, 250

Climate change (as a driver of FGM/C and early marriage) ­117, 246, 257, 260

Colombo, Daniela 47, 49

Colonialism, coloniality, neocolonialism (also see decolonial, neocoloniality, neo-imperialism) 7, 15, 17

borstals (colonial Kenya) 61

colonial interventions 15–16, 18, 61, 65

colonial medicine 16 n. 9, 61, 61 n.2

colonial mindset 15, 202

colonial power structures 202

colonial roots of state regulation in Africa 60, 61, 65

colonialist discourses 51, 53

coloniality of power (re FGM as a term) 155 n. 1

critiques of 58, 62

cultural imperialism 196, 197

laws (influence of) 63–4

legacies of 1–7, 10, 15–17, 18, 47, 48, 62, 188, 189, 191, 295

missionaries (also see missionaries)

French West Africa 15, 16, 16 n.10

Kenya 15, 61, 268

Northern Sudan 16

opposition to FGM/C 15, 16

violence of 17

Communities (also see community-based organisations or CBOs) 3, 4, 5, 7, 12, 13, 14, 15, 19, 20, 21, 23, and book passim

capacity strengthening (see Chapter 5 passim)

community dialogue 12, 249 (see Chapters 5 and 6 passim)

community-generated research/data gathering 117, 118, Chapter 5 passim

community leaders 12, 31, 33, 37, 90, 124, 144, 150, 211, 246 n.2, 251

community-led initiatives 37

community movement (towards abandonment) 249, 251, 253

community ownership 123, 125, 126,131, 132, 234, 248, 254, 255, 264, 273

community researchers (see Chapter 5 passim)

communities of identity (Somaliland) 101

diasporic (see Chapters 8, 9 and 10)

and defence of tradition 283

and community surveillance mechanisms 274 n. 16

Community-based organisations (CBOs) 37, 97, and passim

Community surveillance programmes (aka mech­anisms) 274, 274 n.10

Conferences (on human rights issues including FGM/C and violence against women) 5

Beijing (1995) (Fourth World Conference on Women) 32, 45

Burkino Faso (2009) 50

Cairo (1994) (International Conference on Population and Development) 31–2, 208

and Declaration for the Elimination of FGM 209

Copenhagen (1980) (World Conference of the UN Decade for Women, aka the Second World Conference on Women, or the interim conference) 45, 46–7, 48

Dakar Regional Seminar on Traditional Practices Affecting the Health of Women and Children (1980) 212

Mexico City (1975) (First World Conference on Women) 44–5

Nairobi (1985) 45

Seminar on Traditional Practices Affecting the Health of Women and Girls (aka ‘the Khartoum seminar’, 1979) 46

Vienna (1993) (Vienna Conference on Human Rights) 30, 50

Women’s Tribune event (Mexico City 1975) 45

Côte d’Ivoire 85, 86, 87, 88, 89, 177

Council of Europe 32, 209

Councils of elders 75, 277

in colonial times 15

COVID-19 pandemic 113, 117, 127–8

and link to rise in FGM/C 113, 117 (school closures)

Crime (also see criminalisation, male circumcision, FGM/C, laws/legislation) 59, 73, 75, 76, 95, 121, 139, 154, 155, 156, 164, 169, 194, 201, 202, 207, 209, 210, 217, 218, 219, 225, 230, 231–3, 237, 240, 252

‘hidden crime’ (UK) 155, 164, 169

Criminalisation (of FGM/C) 73, 217, 218 (and much of Chapter 11)

as a deterrent 217, 219

discourages reporting 218

drives FGM/C underground 20, 75, 95, 191, 202, 207, 215, 218, 224, 225, 230, 232, 237, 260

in the UK (see Chapter 8 passim)

in other parts of the world 12, 43, 59, 190, 231–3

and critiques/discussion of (see Chapters 8 and 12 passim)

Cross-border FGM/C 37, 207, 214, 215

drivers of 241

textbox 241

Christianity (also see bible, religion, religious leaders, colonial missionaries)

correlation between belief and FGM/C (see Chapter 4)

denominations (Catholic, Protestant, Pentecostal, other) 8, 15, 16, 16 n. 9, 83, 84, 87, 277 n.22, 278 n.23

Cultural Rights and Kenya’s New Constitution (research project) 270 n.9

Cultural rights 9, 20, 42, 61, 68, 70, 71, 73, 208, 221, 270, 271, 293

cultural rights activism 271

and balance with human rights 68, 293

Culture/cultural (also see tradition, traditional cultural practices, traditional cultural associations and groups, Chapter 14 passim) 7, 8, 17, 39, 41, 42, 43, 47, 49, 51, 54, 55, 56, 58, 59, 63, 64, 70, 71, 76, 78, 79, 80, 126, 157, 169, 174, 189, 196, 200, 213, 221, 222, 251, 265, 266, 294

as a social construct 271

as a way of life 271, 271 n.11

as a driver of FGM/C 265, 294

attachment to FGM/C as a cultural or religious obligation 239

‘culture wars’ (Kenya) 70

cultural ambiguities 60

‘cultural crimes’ (perception of, in UK) 168/9

cultural custodians 92

cultural diversity and FGM/C 52, 95, 282

cultural essentialism 56

cultural heritage/traditions 36, 272–3, 293

cultural identity 28, 62, 71, 111, 269

cultural performance 275

cultural practices (and views of) 42, 43, 44, 49, 55, 59, 95, 268

cultural sensitivity 36–7, 41, 169, 265

demonisation of (Maasai culture) 270

FGM/C as a cultural issue 265 (also see Chapter 14 passim)

seen as culturally significant practice 211

fluidity of 265

notions of 243, 265, 266 (and Chapter 14 passim)

stigmatisation of Somali heritage communities in UK 95 (see Chapter 8 passim)

Western 174, 281

and culture seen as ‘good’ or ‘bad’ 249, 251

and patriarchy 157

and religion 80, 92

Cultural anthropology 45, 271 (also see anthropology)

Cultural relativism 1, 8, 17–18, 39, 63, 76, 95, 222

tensions between this and universal human rights 38–9, 281

and ethnocentrism 281

and Franz Boas 281

and harm 281

and neo-imperialism/neo-colonialism 43, 176, 281

textbox 281

Cut/cutting (also see terminology, WHO types, FGM, FGM/C, FGC, FC, male circumcision, and other terms for the surgical alteration of male and female genitalia for non-medical reasons. Genital cutting is not indexed) 3 n.2, 4, 9, 11, 12, 13, 14, 16, 19, 21, 22, 56, 87, 9, 99, 100, 105, 105 n.2, 106, 107, 110, 111, 113, 114, 116, 117, 120, 121, 121 n.2, 122, 129, 130, 131, 135, 137, 171, 176, 178 n.12, 184, 185, 197, 198, 204, 207, 212, 214, 216, 218, 231, 232, 233, 241, 243, 246, 247, 248, 249, 280, 288, 290, 294

Daly, Mary 46

Data (also see research, methodology, DHS, KDHS, SDHS) 18, 19, 26, 31, 33, 34, 36, 37–8, 41, 77, 84–6, 88, 89, 102–5, 109, 111, 117, 118, 132, 136, 139, 141, 145–7, 148, 149, 158, 159, 167, 188, 195, 225–8, 238, 248, 262, 263, 264, 273, 273 n.15, 288, 290, 291–2

analysis of 85, 89, 104, 105, 142, 143, 145, 147, 148, 149, 159, 245

benefits of community-generated data 117, 118 (see Chapter 5 passim)

data gathering/collection 31, 33, 34–5, 39, 41, 104, 105

data reliability 118, 153 (UK), 170, 255, 263

MICS data 38, 136, 291

non-neutrality of 19

prevalence data (including limitations of) 19, 37–8, 40, 153, 156, 158, 160, 188, 238, 248, 291

and self-reporting bias 238

Dawoodi Bohra sect 282, 282 n.1, 284

Decolonial 18, 25, 58

approaches to male and female genital cutting 62–4, 76

lenses 62

perspectives and stances 18, 52

Demographic and Health Surveys (DHS) (also see KDHS and SDHS) 38, 77, 84, 85, 86, 87, 121, 291

data 77, 84–6

limitations of 291

questions about FGM/C 85, 121

Development (also see NGOs, UN, named agencies and NGOs, Sustainable Development Goals) 7, 13, 15, 20, 32, 34, 35, 48 n.7, 55, 56, 92, 93, 94, 98, 188, 204, 233, 247, 254, 257, 285, 289

development agencies (see named agencies)

and short-term funding cycles 39

development interventions (coloniality of) 15, 92

faith-based approaches to (see Chapter 4)

Diaspora (for African women, see Chapters 8 and 9 in particular) 36, 37, 169

African identities seen as ‘incompatible with British values’ (UK) 170

African heritage communities seen as deviant (UK) 170

Dilemmas

decision-making dilemmas 13, 22, 97, 106, 111, 112, 114, 117

decision-making processes in households 91, 106

Discourses (see Chapter 2 passim) 2, 7, 25–6, 43, 44, 58, 6, 159, 170, 247

changes over time (see Chapter 2 in particular)

colonialist 51

Discrimination (also see women, girls. These entries mostly refer to gender-based discrimination) 3, 29, 30, 31, 32, 47, 49, 50, 57, 165, 166, 195, 201, 208, 226, 283

African women compared to European women 47

class based 201

ethnic 226, 283

in UK (against Somali heritage communities) 165, 166

intersectional forms of 201

Dorkenoo, Efua 173, 173 n.4, 176, 183

Earp, Brian 10, 16, 63, 75, 189

Education (also see schools, teachers, anti-FGM/C curriculum) 7, 12, 17, 21, 24, 32, 33, 37, 38, 68, 106, 115, 120, 124, 129, 133, 137–8, 150, 162, 163, 170, 183, 184, 188, 202, 214, 222, 234, 235, 247, 248, 249, 256, 261, 290, 290 n.3, 294 295

of communities 1, 38, 92, 214, 222, 248, 256, 261 (and the book passim)

rights to 18, 29, 37, 38

as a component of Alternative Rites of Passage 266

Egypt (also see case study in Chapter 10, 198–200) 2, 9, 78, 83, 85, 86, 87, 88, 89, 138, 153, 187, 188, 190, 202, 208

Al-Azhar University 78

Cairo Declaration for the Elimination of FGM (2003) 209

deaths of girls (2007) 83

decree (partly) allowing FGM/C in hospitals (1994) 190, 198

later reversal (1996) 190, 198

and 2007 ban on health professionals performing it 198

earliest campaigns against FGM/C 208

Egyptian Society of Physicians 208

fatwa (2007) 83

FGCP (reframed as a cosmetic operation) 201

FGM/C fully banned (2008) 198

FGM-Free Village Program 83

healthcare professionals and providers 198, 199, 200, 202

Equality Now (NGO) 36, 270 n.9

Eradication (also see zero tolerance) 5, 14, 16, 17, 25, 31, 32, 110, 143. 149, 1`50, 204, 210, 212, 219, 221, 223, 235, 240, 243, 245, 247 n. 2, 253, 256, 264, 266, 268, 283, 289

arguments against this approach 204, 225, 226

Esho, Tammary 270

Ethics (also see bioethics) 68, 294

ethical commitment to knowledge co-production 161–2

ethical concerns 95, 136, 225, 227, 231

ethical consistency 62–4

ethical debates 284

ethical dilemmas 62, 76, 184

ethical research practices 103, 105, 145, 161–2

ethical responsibilities of healthcare professionals 113

Ethiopia 4, 40, 84, 86, 87, 88, 90, 92, 172, 241

Ethnicity (also see named ethnic groups) 7, 72, 75, 80, 81, 197

Ethnocentric/ethnocentrism 11, 39, 46, 63, 76, 189, 281, 284

Ethnography (also see anthropology) 44, 52, 55, 57, 58, 65, 69–70

ethnographic literature on genital cutting 10

ethnographic research 52, 53, 65, 68, 275, 280, 286

Eritrea 85, 86, 87, 89, 90

anti-FGM/C community committees 217

anti-FGM/C laws 217

Eurocentrism 14, 204

European Network Against FGM 174

European Commission 35

European Parliament 209, 209 n.2, n.3

European Union (EU) 34

Excision (also see FGM/C and other terms for it) 54, 56, 60 n. 1, 134, 173, 176, 177, 179 n.15, 180, 182, 184, 269

as a political issue for anthropology 54

in colonial Kenya 16 n.9

Faith and faith groups (also see religion, religious leaders, Christianity, Islam, Chapter 4 passim)

engaging faith leaders 26, 51, 79, 80, 81, 151

faith-based approaches 93–4

faith-based organisations 79, 80, 93

faith communities 91

Muslims/Muslim faith 84, 89, 90, 94, 151, 170

and Joint Learning Initiative on Faith and Local Communities (UK) 51

Female circumcision (FC) (also see other terms for it) 2, 11, 25, 31, 40, 44, 78, 157, 190, 192, 195, 196, 197, 198, 210, 224, 225, 226, 227, 228, 229, 230, 231, 235, 239, 240, 260, 267 n.4, 284

false binary opposition with male circumcision (colonial roots of) 10

female circumcision crisis (colonial Kenya) 8, 15, 224, 268

Feminism/feminists 18, 25, 45, 46, 47, 51, 53, 58, 59, 186, 188, 285, 291

African 47–8, 285, 291 (also see references to the Global South in Chapter 2)

American feminists 7, 45–6, 49, 53

feminist approaches to research 162

feminist disagreements and discourses (Global North and South) 43–4, 45, 46, 47, 48

international feminist movement against FGM/C (start of) 44

intersection with anthropology/anthropologists 44, 53, 54, 55

second wave 45, 194

Western/northern/’white’ feminism 29, 45–6, 47, 48, 54, 58

Female Genital Cosmetic Procedures (FGCP) (aka Female Genital Cosmetic Surgery, FGCS) 14, 50, 153, 158, 159, 169, 221, 283, 284, 285, 293, and see Chapter 10 passim

aesthetic and other reasons for the practice 188, 199

‘correction of abnormal genitalia’ 199

genital variations framed as abnormalities 188

beauty norms/standards (unrealistic) 188–9

penalties for failing to meet them 189

interplay between Western beauty norms and medicalisation 188, 199

blurred lines between this and medicalised FGM/C 153, 204, 283, 293 (see Chapter 10 passim)

cosmetic surgeons 188, 296

data (lack of reliable) 188

debate around parallels with FGM/C 189

definition of harm (call for more consistent) 202

double standards 187, 200, 203; shaped by colonial legacies 192

Dutch case study 190–5

Egypt case study 198–200

decrees and legislation against medicalised FGM/C 198

genital surgery seen as cosmetic operations 199

feminist views on the rise of 188

framed as an informed choice 194

global increase 159

health risks of 24, 31, 33, 194

historical background 190–2

‘indicated’ and ‘non-indicated’ genitalia for cosmetic correction 199, 201

Kenya case study 195–8 (also see Tatu Kamau, Chapter 12)

race and class aspects 190, 197

role of health professionals 187, 198, 199

social and cultural pressures to have it 189

types of: hymenoplasty 188; intimate peeling 188; introitoplasty 188; labiaplasty 188, 194, 198, 201; vaginal rejuvenation 188

what FGCP is 188

WHO failure to classify it as FGM/C 24, 193

and bioethics 194

and ethnocentrism 189

Female genital mutilation/cutting (FGM/C) (also see FGM passim, female circumcision, excision, other terms and terminology, medicalisation, legislation, etc.) 1, 2, 33, 42, 44, 49, 60, 90, 119, 187, 193, 204, 236, 282

abandonment (and moves towards it) 3, 7, 13, 14, 19, 20, 21, 23, 28, 32, 33, 37, 41, 83, 91, 92, 94, 97, 99, 101, 102, 106, 112, 113, 114, 115, 116, 117, 118, 124, 137, 138, 139, 140, 141, 142, 143, 144, 145, 146, 149, 150, 191, 204, 212, 239, 240, 251, 283, 288, 289, 290, 201, 202, 294

as a rite of passage 137, 240, 246, 281, 283

barriers to change 100, 268, and the book passim

changes over time 4, 19, 131, 138 (also see change)

consent 194

debates about validity of 197

consequences for male partners 167

cross-border (see cross-border FGM/C entry)

cultural aspects of (see culture/cultural)

seen as safeguarding traditions and morality (also male circumcision) 228

curriculum (attempts to include FGM/C) 109, 115, 256, 261

and midwifery curriculum 4

cuts of less severity 4, 83, 99, 111, 113, 135, 137, 151

diaspora (FGM/C in the, see Chapters 8, 9, 10)

driven underground (by criminalisation) 20, 75, 95, 191, 202, 207, 215, 218, 224, 225, 230, 232, 237, 260

drivers of 77 (religious), 94, 254, 265

early cutting to avoid detection 95, 216, 238, 246

education (role of) 37

historical continuities 10, 15, 17, 73, 268, 270

historical roots of 2

integrating FGM/C work into other development initiatives 21, 97–8, 119, 127

laws against 12 (see legislation, individual countries)

lived experience of 227

opposition/resistance to 5, 48, 73, 125, 213, 215, 224, 235, 237, 239, 240, 252, 254–5, 269, 270, 284

perpetrators of (see circumcisers/cutters, TBAs) 213, 215, 218, 224, 236, 237

polarised approaches (to this and male circumcision) 62, 283 (see Chapters 3 and 12)

prevalence (global, for UK see UK) 1, 1 n.1, 19, 38 (see individual countries)

male engagement with 6 (see men, boys, elders, stakeholders)

mandatory reporting of (UK) 157, 162, 163, 218, 295

non-cutting alternatives (see Bondo, ARP, CLARP)

normalisation of 288

‘survivors’ of 29, 74, 102, 171, 174, 175, 176, 183, 186, 216, 223

stigma of 38

transitioning girls to women (role in) 12, 14, 248, 254

types of (WHO classifications) 3–4, 9, 187 (also see WHO)

and adult women 119, 170, 195, 196, 197, 201, 221, 231, 293 (right to choose)

and impacts of climate change/drought 246

and links to teenage pregnancy, school drop-out, early/child marriage (see Chapter 13 in particular) 247, 251, 258, 258, 262

and pain (endurance of) 252 (also see pain)

and patriarchy 48, 52, 56

and inconsistencies around this and male circumcision (see Chapters 3 and 12)

FGMo (female genital modification) 2, 43, 282

FGM safeguarding (UK) (see Chapter 8 passim) 153, 155 n.2, 156, 161, 166, 167, 168, 169

and government’s FGM-Safeguarding Policy 161, 162–6, 170

criticism of 166, 167 (and Chapter 8 passim)

and stigmatisation of African heritage communities 158

Foldes, Dr Pierre (also see reverse clitoridectomies, aka clitoral reconstruction) 171, 172, 174, 175, 176, 177, 178, 186 (see Chapter 9 passim for Foldes, other surgeons, and patients)

clients (backgrounds of) 178 n.11

Food (largely in relation to male circumcision, Kenya; also see Chapter 3)

food security 21, 286

importance of in healing boys after circumcision 66, 69

mothers as food providers for initiated boys 68, 69

special food for circumcised girls 277

women as food producers 129

FORWARD (women’s anti-FGM/C NGO, Germany and UK) 173 n.4, 183, 183 n.22

Foucault, Michel 92

Foucaldian discourse 43

French West Africa (also see colonialism, missionaries) 16

exchanges between colonial French and British governments 16

medical and ethnographic studies of FGM/C 16 n.10

FRONTIERS (NGO) 91, 91 n. 9

Fusaschi, Michela xii, 51 n.11, 57

Gambia, The 40, 42, 85, 86, 87, 89, 171, 178, 221, 222

constitution 222 n.15

laws (anti-FGM/C) 213 n. 8

traditional circumcisers 82

and MP Almameh Gibba 42, 55

and prevalence 40

and religious leaders 82

GAMS (Group Femmes pour l’Abolition des Mutilations Sexuelles) 174 n.6

Gender 2, 3, 9, 18, 24, 46, 57, 121, 154, 182, 183, 185, 187, 188, 193, 196, 199, 200, 201

circumcision (male and female) as preparation for gender roles 228

gender equality (and disparity) 14 n.7, 29, 32, 138, 139, 155, 196, 221, 230, 232, 252, 287

gender-based discrimination 29, 49 (also see Chapter 12)

gender politics 62, 73, 74, 191

gender-based violence (GBV) 7, 18, 21, 31, 40, 55, 57, 58, 59, 75, 155, 246, 251 n.5, 256 n. 7, 289

traditional gender roles 71, 228

unification of genders (through male and female circumcision) 228

gender-transformative approaches 279

gender-transformed societies 223

Genitalia (also see clitoris, labia, vagina, vulva, etc. These pp do not necessarily refer to specific body parts) 2–3, 9, 18, 24, 46, 57, 121, 154, 182, 183, 185, 187, 188, 193, 196, 199, 200, 229, 280

female genitalia seen as ‘abnormal’ or ‘excessive’ 188, 199, 200

male 121, 173, 226, 229

terminology for the alteration of (also see terminology) 2

Ghana 56, 57 n.4, 188

Girls (also see children’s rights, VAWG, rescue, the book passim)

African girlhood 234

agency of 250, 261

as peer ambassadors 251 n.5

discrimination against cut girls 3, 38

empowerment of 26, 32, 100, 256

education of (see the book passim, some of these entries are not girl specific) 17, 21, 29, 32, 37, 38, 106, 115, 137, 234, 235, 247, 248, 249, 256, 261, 266

out-of-school girls more vulnerable to FGM/C 117

social pressure on 57, 197, 258, 260 n. 9, 260, 261

violence against 30, 33, 239 (also see violence entry and VAWG)

voices (strengthening of) 261

Graamans, Ernst 247, 248, 266 n.3, 268, 274

Groult, Benoîte 46, 53

charges of racism against 53

Gruenbaum, Ellen xii, 6, 189, 270 (also see Afterword, 281–96)

Guinea 9, 52, 85–7, 89, 120

anti-FGM/C law (1965) 208

prevalence 120, 121

types practised 120–1

Guinea-Conakry 9, 97 (also see Chapter 6 passim)

Aniké (Belgian NGO) 119, 122, and Chapter 6 passim

anti-FGM/C law 121

ASD (Association des Amis de la Solidarité Sociale et du Développement, Guinean NGO) 119, 120, 122, and Chapter 6 passim

awareness raising (aka ‘sensibilisation’) 119, 120, 122, 123, 124, 127, 129, 131, 132

beliefs about/community perceptions of FGM/C 119, 123, 124

campaigns against FGM/C (by above NGOs) 119, 120, 122, 123, 124, 131

challenges faced 123, 127–8, 129

characteristics of 121–8

context of 120

evaluation of impacts 131

integrating FGM/C with other types of messaging 119, 129, 130, 132

lessons learned 128

positive outcomes 129, 132

child and maternal health 130

collectives (aka communes) 121, 123

community assemblies 119, 124–5, 131

community ownership 132

COVID-19 (impact of) 127–8

circumcisers (aka cutters, TBAs) 122

DHS 121 n.2

dialogues (in villages) 122, 123, 124, 126, 132

education 120, 124, 126, 129

and training 125 n.3

entrepreneurship (strengthening of) 129, 131–2

FGM/C country prevalence 120–1

FGM/C types 120–1, 121 n.2

health issues (other than FGM/C, e.g. HIV) 128

health posts 127, 128, 130

Kankan prefecture 119, 120

and FGM/C prevalence 121

medicalisation 121, 131

and health practitioners 121, 131

parents 121, 128

Radio Rurale 122, 124–5, 126

social norms 119

stakeholders (including teachers, health workers) 122, 123, 126

elders, ‘wise men’, chiefs 122

elected village representatives 122

moral and religious leaders 122, 123

parents 121, 128

taboos 123, 124; breaking of 98, 128–9, 131, 132

vigilance committees (aka COVIPE, Committees for Vigilance Against the Practice of Excision) 119, 125–6, 127, 128, 129, 130, 131

women’s agency 129, 131, 132

women’s empowerment 127

women’s rights 125

Harm/s (also see trauma) 1, 2–3, 17, 18, 19, 21, 22, 24, 27, 28–9, 31, 46, 50, 67, 73, 79, 83, 97, 109, 114, 115, 136, 191, 194, 196, 197, 201, 202, 203, 208, 259, 281, 283

activist-driven exaggeration (claim of) 227

assessment (lack of objective) 192, 201, 202

call for more consistent definition 202

complications following medicalised FGM/C 196

concept of 46

debate around 196, 197

‘do no harm’ 7, 9, 191, 194, 195

failure to define it 194

FGM/C’s effects on the body 172–3

harm reduction and strategies 9, 13, 14, 17, 18, 20, 95, 112, 156, 161, 190, 202, 204, 288, 294, 295

medicalisation as harm reduction 18, 95, 196, 296

inconsistency in how harm and consent are defined 203

and WHO rejection of this 190–1

perceptions of harm 17, 18–19, 228

psychological effects on girls who report parents 218

and ‘injury discourse’ 74

Harmful practices (aka harmful traditional or cultural practices, see Chapter 2 passim) 7, 29, 32, 34, 40, 43 n.3, 56, 76, 117, 136, 141, 146, 212, 245, 256, 269

critiques of these terms 42–59

discourses around (see Chapter 2 passim)

Health (also see FGM/C, global agendas, WHO) 3, 4, 6, 7, 9, 11, 21, 25, 27, 30, 31, 33, 44, 45, 46, 52, 54

complications following FGCP 194

complications following FGM/C 3, 11, 31, 71, 83, 99, 102, 105, 106, 107, 113, 114, 124, 125, 183, 196, 218, 225, 227, 228, 229, 252

complications following male circumcision 63, 229

global health policies and initiatives 18, 61

health risks (see harm, and complications) 9, 13, 24

lack of healthcare access (for Somali heritage community in UK, see Chapter 8)

sexual and reproductive 50, 51, 81, 213, 220, 232, 249, 250, 250 n.4, 251, 252, 261, 290

rights to 4, 18, 23, 29, 51, 81, 251

Healthcare practitioners (aka health/care professionals, health workers) 8, 9, 12, 113, 114, 122, 123,187, 190, 195, 199, 203, 218, 219, 236, 287, 291, 289

as change agents 9, 288–9

involvement in medicalisation 4, 8, 9, 10, 11, 21, 107, 112–3, 187, 195, 198, 199, 203, 218, 219, 230, 236, 288, 289, 291

involving midwives in abandonment efforts 289

Hosken, Fran 7, 45–6, 47, 49, 53

The Hosken Report 45

Human rights and human rights approaches (also see women’s rights, children’s rights, legislation, Chapters 1 and 11 passim, UN resolutions) 6, 7, 9, 11, 17, 23, 25, 27, 28–34, 38, 39, 43, 49, 50, 54, 56, 57–8, 61, 62, 72, 74, 90. 138, 139, 155, 191, 192, 204, 208, 209, 219, 222, 223, 237, 252, 281, 282, 283, 284, 294, 295

agendas 27

approaches 28–34

competing rights (tension between) 17–18, 68, 284

debates and discourses 43, 284 (see Chapters 1, 2 in particular)

fatigue around messaging 295

FGM/C as violation of 17, 28–9, 209 (and Chapter 1 passim)

framework (global) 57, 58, 222

historical development of 27

international protocols and resolutions 27, 28, 29–30 (see Chapter 1 passim)

challenges of implementation 35–6

language of 58

legislation (see Chapters 1 and 11, also see legislation entry) 9, 49

individual rights 29

universalist stances on FGM/C 11, 18, 28, 39, 95

women’s rights (also see women) 3, 35, 57, 191, 204, 219

Hygiene 74, 230, 253, 256 (needs of communities)

Hymenoplasty 188

Hypervigilance (see UK) 153, 165, 170

Identity (also see named ethnic groups, Chapter 8) 7, 18, 28, 48, 51, 60 n.1, 72, 77, 78, 81, 101, 137, 189, 237, 282, 282, 283, 284

Black and Muslim identities (in UK) 166, 170

Cultural identity 28, 62, 71, 111, 269

identity politics 55

inscribed onto the body in FGM/C 269

Ideologies 17, 233

ideological positions on FGM/C 17

liberal rights-based 17

religious 81 (also see Chapter 4 passim)

Immigrant communities (see diasporas, Bristol research in Chapter 8) 1, 36, 37, 169

Indonesia 90, 191

Infibulation (also see pharaonic cut) 3, 5, 16, 22, 82, 83, 99, 105 n.2, 134, 151, 159, 175, 176, 190, 284, 289, 290

and deinfibulation 105, 284

Initiation (male and female; also see FGM/C, initiation ritual, Alternative Rites, male circumcision) 61, 64, 65, 67, 68, 69, 74, 75, 235, 243, 248, 249, 254, 261, 268, 268 n.8, 271 n.10, 272, 274, 275, 277, 279, 293

importance of emotion in initiation ritual 276

meaning of 274–6

state control over 61, 64

uses of ritual in 274–6, 280

Institut en santé génésique (Women Safe & Children, Paris) (see reverse clitoridectomies) 75, 178 n.11, 180

Integrate UK (Bristol youth charity, see Bristol research) 160, 160 n.6

International instruments and protocols 25, 27, 35, 36, 208 (also see Chapter 1 passim)

International Covenant on Civil and Political Rights (1966/1976) 208

International Covenant on Economic, Social and Cultural Rights (1996) 208

Protocol to the African Charter on Human and Peoples’ Rights on the Rights of Women in Africa (aka the Maputo Protocol (2003) 32, 37, 50, 209

and historical development of (see Chapter 1 passim)

International Planned Parenthood Federation 100, 102, 116

Intersectionality (in relation to FGM/C) 20–1, 47 n.6

Intersex Genital Mutilation (IGM) 11, 229, 283, 294

Introitoplasty 188

Iraqi Kurdistan 90

Islam 51, 78, 79, 82, 83, 92, 93, 137, 151; for Islam and Muslims see Chapter 4 passim

International Islamic Center for Population Studies and Research 78

Islamic Ruling on Male and Female Circumcision 78

Islamic scholars (ulama) 92, 93

Islamic schools of thought: Maliki 89–90; Shafi’i 89–90, 94; Shi’a 282; Sunni 89–90, 151

Islamic State (ISIS) and Yazidis 82, 83

theology 78, 79, 82, 83, 93, 94

delinking FGM/C from Islamic theology 78

and fatwas (Somaliland) 82, 83, 109, 113, 116; (Puntland) 151; (Egypt) 83

and haram 82

and perceived links to FGM/C 21, 84

and shariah 92

and sunnah (see entry for sunnah)

and the Quran 79, 151

Istanbul Convention (Council of Europe Convention on preventing and combating violence against women and domestic violence, 2011) 32, 37, 209, 209 n.1

Johnsdotter, Sara 8, 288

Kajiado County (Kenya) 211, 243, 245, 246–8, 262, 263, 270 n.9, 273, 276 n.19

anti-FGM/C policy 247, 247 n.2, 251 n.5, 256

Kamau, Tatu xiii, 205, 272 n.12, 224; also see Chapter 12 passim, Kenya, male circumcision, and Kenya case study in Chapter 10 (195–8). For named legislation, see Kenya

and 2017 lawsuit (Kenya) 153, 195–8, 202, 221, 222, 225, 293

and 2021 judgement 246, 293, 201

colonial legacies 224, 225, 234–5

community surveys (methodological challenges) 225

concealment or denial of FGM/C to avoid prosecution and stigma 238

constitutional discrepancies 239

cosmetic genital surgery (aka FGCP, rise of) 226, 230

criminalisation and its effects (also see criminalisation) 202, 225, 230, 232

cultural norms and the law (contradictions between) 229

cultural reasons for practising male circumcision (Kenya) 227

discriminatory targeting of ethnic groups 225, 235

gender/other disparities between approaches to male circumcision and FGM/C 225 225, 226 (and Chapter 12 passim)

eradication deadlines (global fixation on) 226, 238

ethical concerns 225, 227, 231

governmental and NGO double standards (Kenya) 229

health risks of FGM/C exaggerated 225, 227

medical practitioner perspectives 225

author’s experience in clinical settings 227–8

medicalisation 229, 230, 240

disparity between medicalised approaches 225, 226

and harm reduction 229

and involvement of health professionals 230

resistance to anti-FGM/C law 224, 232, 236, 237, 240

sustainable change from within communities (call for) 240

and reliance on community surveys for monitoring prevalence 237–8

and women’s rights to culture 196–7

and WHO 229

Kanyonyo, Juliano (also see male circumcision)

death of 60, 62, 65, 68

media coverage of 67

mother of 66, 67

mothers generally (and male circumcision) 68–70, 73

role of mentors 66, 67

and activism by mothers and women MPs 61, 62, 73–4

and hazing 63

as a symbol 65

Kenya (also see laws/legislation, Kamau, Kanyonyo, male circumcision, colonial legacies, named ethnic groups, Chapters 3, 12, 13, 14, and Kenya case studies in Chapters 10 and 11)

anti-colonial struggle (Mau Mau) 15, 15 n.8

Anti-FGM Board 215, 246, 246 n.1, 266 n.3, 271 n.10, n.11

anti-FGM/C laws and policies 224 (first of)

ban on medicalised FGM/C in clinics and hospitals (2010) 210 n.4

Health (Amendment) Act 2020 60, 72–3

National Plan of Action for the Elimination of FGM (1999) 210 n.4

National Policy for the Eradication of Female Genital Mutilation (2010) 210

The Children Act (2001, amended 2022) 210, 210 n.4, 231, 246

The Prohibition of FGM Act (2011) 61, 67, 224, 225, 229, 231, 236, 237, 246, 246 n.1

and prosecutions 213–4, 216, 237

Constitution (2010) 239, 271 n.9

and cultural rights 70, 239 n.14

counties and devolution 74, 247 n.2

ethnic politics 225

female circumcision crisis (colonial era) 8, 15, 224, 268

FGM/C prevalence (national) 239, 246

government ministries, departments, etc.

Ministry for Gender, Children, and Social Affairs 211

Ministry of Culture and Social Services 250

National Commission on Gender and Development 211

Office of the Director of Public Prosecutions 237 n.13

Kajiado County (see separate entry)

Kenya Women’s Parliamentary Association 211

KDHS (Kenya Demographic and Health Surveys) 227, 236, 237, 239, 240, 246, 262, 263

issues around/limitations of data 237–8, 263

self-reporting biases 238

legislative framework 61 (also see case study in Chapter 11)

medicalisation

female 230, 236

male 72, 73, 229

and role of health professionals 236

Penal Code 246

state regulation of male and female circumcision 60, 61, 70–1, 73, 75

types of FGM/C 227–8

and colonial era (also legacies of) 3 n.2, 8, 61, 190, 224, 225, 234–5

Kikuyu people (Kenya) (also see male circumcision, Leakey)

councils of elders 64, 71

FGM/C prevalence 239

traditions 271, 272, 272 n.12

and female circumcision crisis (colonial Kenya, see Kenya entry)

and role in the independence movement 210

Kisii people (Kenya) 75, 235 n.8, 236 n.9, 238, 246

FGM/C prevalence 236, 238, 246

resistance to laws/controls 236

Kissi people (Upper Guinea)

and research on ‘genital mutilation’ 52

Knowledge

dissemination of (research findings) 102, 108–9, 110, 111

production 52, 53

and androcentrism 52

and co-production 161–2

locally owned 101, 117, 118

Kortum, Jeanie 171, 179, 184, 185

Kratz, Corinne 275–6, 276, 280

Kuria people (Kenya) 211

girls cut during COVID lockdown 232–3

public protests against FGM/C laws 211

Labia 175, 183, 188, 192, 283, 285 (also see labiaplasty)

seen as ‘excessive’ or too large 188, 189, 199

and WHO types of cut 24

Labiaplasty (also known as labial reduction) 11, 159, 188, 189, 194, 198, 201, 293

Leakey, Louis 268, 268 n.8, 279

Laws and legislation (anti-FGM/C; also see named countries, Chapter 11 passim) 4, 8, 9, 12, 20, 29, 30, 32, 33, 33 n.11, 35, 36, 43, 49, 58, 59, 61, 65, 67, 69, 72–3, 74, 75, 82, 121, 138, 139, 155, 156, 157, 160, 169, 170, 193, 196, 201, 205, 207, 210, 211, 213, 216, 217, 218, 219, 220, 221, 222, 224, 231, 236, 246, 256, 264

in Africa 4, 36, 20, 72, 207, 209–10 (see Chapter 11 passim)

adoption of 209–10

challenges faced after laws passed 139, 207, 211, 212, 214–16

community-level enforcement 217, 223

customary law 71

deterrent effects 214, 215, 216–17, 218, 219, 220, 223

development of 207–8 (see Chapter 11 passim, largely for Africa)

domestication of international laws 35–6, 37, 40, 138, 210

limitations of law as strategies of change 291, 292

harmonisation of 241

impacts (also see criminalisation) 59, 207

implementation challenges 35–6, 197, 213–17

policy and legislative context (regional and global) 208–9

prosecutions (paucity of, see case studies below) 207, 213–14

should the law be used to change social behaviour? 222

and cross-border FGM/C 197, 207, 214, 215, 216

Kenya case study (in Chapter 11) 210–12; for named laws, see main Kenya entry

arrests, prosecutions and convictions 213–14, 216

community resistance/protests 211, 215

criminalisation of victims 216

and their re-victimisation 216

what the law bans 214

women MPs (activities of Jebii Kilimo, Sophia Abdi Noor) 211

Senegal case study (in Chapter 11) 212–13

community resistance 215

cross-border FGM/C 215

education and awareness-raising drives 214

few arrests and convictions 214

medicalisation 214

public declarations 215, 215 n.10

what the law bans 214

in the diaspora 36, 209, 209 n.2 and 3

in the Middle East 36 n.16

in the UK (see UK, and Chapter 8) 156, 157, 170

Liberia 40, 241

prevalence (decline in) 40

Mackie, Gerry (also see social norms theory) 12–13, 13 n. 6, 260 n. 9

Malaysia 90

Maendeleo ya Wanawake (MYWO, Kenyan women’s NGO)

and earliest Alternative Rites of Passage 233, 247, 273 n.15

and PATH (NGO) 233, 247

Maasai (also see Amref Health Africa, ARP, CLARP, Chapters 13 and 14) 271

age-sets 272, 277–8

cultural context of CLARP 255

cultural identity 269

FGM/C seen as inscribing identity onto the body 269

cultural heritage/traditions 246, 255, 261, 269, 276, 277–8

culture

‘harmless’ aspects of 251

demonisation of 270

denigration of practising communities 269

FGM/C prevalence (Kenya only) 238, 246

gender-based violence (GBV) 246

girls 260–1

younger age of cut 246

identity 269

marginalisation of 279

motives for practising FGM/C 247

vulnerability to climate change 246, 260

traditional circumcision ceremonies 275

views of FGM/C 276–7, 278

women 246, 278

protests against anti-FGM/C laws 211, 278

upgrading of (FGM/C’s role in) 272

warriors 249, 277

and Alternative Rites of Passage (see Chapters 12 [233–4], 13 and 14)

women’s views of 278

Loita Rite of Passage 267 n.6

Male circumcision (also see Kanyonyo, Kenya, Chapters 3 and 12 passim) 3 n. 2, 10, 195, 196, 283, 294, 296

as HIV prevention 227

balance between human and cultural rights 68

binary opposition (false) between male and female cutting 10, 63, 66

call to bring them into the same analytical framework 76

ethical inconsistency between the two 62

interplay between the two 10, 60, 64, 75

boys’ avoidance of females 66, 69

‘botched’ procedures (deaths and injuries) 63, 67, 71, 228

churches 70, 71, 74

role in elevating women’s roles 71

role of in regulation 70

circumcisers 64, 70

colonial roots 60, 72–3

and colonial legacies 63

and decolonial approaches 76

and medical missionaries 60, 61, 61 n. 2

constitutional protections (Kenya) 68, 70

cultural ambiguities around male cut 60

cultural practices (‘good’ and ‘bad’) 67

global prevalence 226

health benefits (claims of) 197, 226

Jewish 284

legislation (Kenya) 66, 69, 72–3

Maasai 272 n.10

masculinity (shaping of) 69–70

masculinisation/transition to manhood 66, 68

medicalisation (colonial era) 60, 61 n.2, 66, 70

modernday 62, 63, 75, 225, 230

moral frameworks 71

denial of moral equivalence with FGM/C 10

mothers’ and women MPs’ advocacy 62, 65, 73, 74

mothers’ safeguarding concerns 67–8, 71, 73

mothers’ role as food providers, regulators 66, 68–9

Muslim 284

neonatal 10, 11

state regulation/intervention 60, 67, 73, 74, 75, 76, 225

and disparity between this and regulation of FGM/C (Kenya) 225

role of fathers 70

seclusion huts for boys 66, 67, 71

symbolic separation from mothers 69

symbolic transformation of boys’ bodies 68–9

traditional (male) groups and associations (resurgence of) 70, 75

conflict between church leaders and traditionalists 70

and role of elders in contesting definitions of morality 70

Traditional Male Circumcision (TMC) 64–5, 64 n.4, 276 n.21, 277

United States (highest prevalence of) 226

unsafe practices (see Chapter 3 passim)

and consent (lack of) 227

and critical scholarship of male cut (paucity of) 61 n.2

and hazing (bullying) 63, 67, 71

and human rights discourses 67

and identity 72

and legislation 69, 71

2020 Health (Amendment) Act 72

2011 Prohibition of FGM Act 72, 73

how they demonstrate interconnectedness between male and female cut 72

and mentors (of boy initiates) 66, 67, 70, 71

and neonatal circumcision (US) 5

and pain 67–8, 71

and personhood/passage to adulthood 69, 72

and victimhood 74

and violence 25, 66, 67, 68, 69, 228

legitimisation of 67

and vulnerability of boys 68

and WHO 69, 229

and VMMC (see separate entry below)

Mali 40, 177, 179, 184

data on 85–7, 89, 213 n.8, 215 (lack of)

Marriage (also see bridewealth) 64, 72, 105, 107, 174, 234, 235, 246, 261, 283, 285

Child, early and forced 14 n.7, 59, 79, 124, 125 n.3, 126, 127, 128, 175, 234, 247, 248, 235

marriageability (and FGM/C) 111, 199, 247, 288, 290

role in upgrading women 272

Mauritania 85–7, 89

anti-FGM/C laws 213 n. 8

Media (also see Guinea-Conakry and Radio Rurale, coverage of Kanyonyo death) 5, 8, 12, 22, 31, 34, 67, 68, 70, 82, 113, 156, 208, 211, 228, 232, 233, 261, 267; also see links to media coverage in notes passim)

coverage of FGM/C in UK 156, 159, 162, 163, 164

discourses and debates 8, 159

film 172, 284

media hype 5, 227

radio 12 (also see Chapter 6)

social media 12, 100, 109, 186, 295

TV documentaries 172, 161, 184, 184 n. 22

Western media 95

and promotion of ‘unrealistic’ beauty norms 188, 199

Medicalisation (largely of FGM/C, and male circumcision) 8–10, 11, 12, 16, 17, 18, 21, 61, 63, 65, 72, 75, 95, 100, 105, 112, 113, 114, 121, 137, 154, 191, 196, 202, 214, 221, 229, 230, 231, 240, 252, 287–9, 291, 292, 296

blurred line with genital cosmetic surgery/FGCP 188, 189 (see Chapter 10 passim)

debates around 95, 154 (and the book passim)

highest rates in Africa 9

medical framing of FGM/C 199

rise in 8–10, 11, 136 (also see individual countries and research studies)

and gender disparity 221, 225, 230

and involvement of health professionals (see under heathcare practitioners)

in colonial Africa 16–17

and ‘the medicalisation conundrum’ 287–8

Men and FGM/C (also see boys, male circumcision, patriarchy)

as fathers 70, 102, 106, 250, 252, 254

authority of 64, 202 (also see references to traditional authority)

engagement with boys and men 6, 100, 101, 102, 106, 109, 112, 114, 115, 122, 124, 125, 126, 129, 249, 250, 251, 254, 256

male domination (FGM/C as) 175

violence by and towards boys and men 25 (see Chapter 3; also see gender violence)

and androcentrism 52, 53

Merry, Sally Eagle 55, 57

Meru, and Meru people (Kenya) 64, 65, 68, 70, 75, 247, 268, 273

Methodology (also see research, studies described in several chapters) 65–6, 84–5, 94, 140, 238, 257, 267

baseline and endline assessments 101, 102, 112, 123–4, 150, 273 n. 15

and comparisons 262

Difference-in-Difference 245, 262, 262 n.11, 263

focus group discussions 103, 161, 267, 267, 276–9, 276 n.19

key informant interviews 103, 104

stepped-wedge random control trials 245, 262

and Participatory Community-Based Research (PCBR, Somaliland; see Chapter 5 passim for a study that uses this methodology) 99, 100, 101–4, 108, 117–18

challenges of PCBR 101, 104

Middle East (also see named countries) 1

laws (anti-FGM/C) 36 n.16

prevalence data 38

Midwives/midwifery (also see TBAs, medicalisation, healthcare practitioners) 4, 9, 16, 106, 113, 114, 136, 164, 168, 199, 230, 288, 289, 290, 292

Migration and FGM/C (also see cross-border FGM/C) 1, 8, 11, 35, 37, 38, 158, 294, 295

immigrant communities (see Chapters 8, 9)

Missionaries (in colonial Africa; also see Christianity, colonialism, religion textbox) 3 n.2, 7–8, 15, 16, 21, 61 n.2, 81, 151

Church Missionary Society (CMS) 235

medical missionaries 16, 61

and female circumcision crisis (colonial Kenya, see female circumcision)

Morality

indigenous moralities (aka local moral worlds) 46, 49, 60, 70, 228

moral commitment (to ending FGM/C) 110

moral conflicts 11

moral occlusion 63, 75

moral panic 8

moral reasoning 75

moral systems and values (in Africa) 39, 46, 81, 228

Multisectoral Academic Program to Prevent and Combat FGM/C (MAP-FGM) 35, 35 n.15

NAFIS (Network Against FGC in Somaliland) 108

Neocolonialism/neocoloniality 7, 15, 17, 18, 47, 63, 204

neocolonial approaches 46

neo-imperialism 281

Netherlands (The) (see Dutch case study in Chapter 10, and FGCP)

Dutch Penal Code 193

Dutch Society for Aesthetic Plastic Surgery 193

Dutch Society for Plastic Surgery 193

Dutch Society of Obstetrics and Gynaecology 193

healthcare inspectorate (investigation and report) 193, 194

healthcare professionals 190, 195

medicalised FGM/C

distinction made between this and FGCP 200

limited public awareness of 200

rise of 189–90

plastic surgeons 193, 195, 196, 198, 200

position papers (2008) 193, 194, 195

Veerman magazine article (2007) 192, 192 n.1

NGOs (non-governmental organisations), also see named NGOs 7, 14, 15, 33, 34, 35, 37, 55, 56, 74, 90, 91, 92, 93, 99, 100, 106, 108, 114, 122, 128, 129, 130, 135, 204, 210, 212, 214, 218, 230, 233, 243, 247, 248, 263, 265, 266, 270, 270 n. 9, 272, 273, 274, 278, 279, 290

secular NGOs 26, 77, 94

and models of development 93

and terminology 22

Niger 85–7, 89

Nigeria 40, 83–9, 84, 85, 86–7, 89

prevalence rates 40, 84

Norwegian Agency for Development Cooperation (NORAD) 102

O’Dey, Dr Dan mon (also see reverse clitoridectomy, Pierre Foldes) 171, 183–4

and Center for Reconstructive Surgery of Female Genitalia 183

Okiek people (Kenya) 272

ethnography of 275

traditional female initiation rituals 275, 276, 280

and Corinne Kratz 275, 280

Orchid Project (NGO, UK and Kenya) 78, 102

cultural significance of 67–8, 71, 247

management of (in medicalisation) 230, 252

and circumcision (male and female) 67, 68

and preparation for adult life 67–8, 71

PATH (Programme for Appropriate Technology in Health) 247

and (with MYWO) Alternative Rites of Passage (Kenya) 233, 247, 273 n.14

Parents (also see sub-entries under other headings) 9, 18, 66, 71, 102, 114, 122, 128, 198, 218, 246, 249, 250, 261, 273, 275, 277, 288, 295 (for other engagement, see book passim)

sensitisation of 102, 114, 115 (and communities generally: 215, 219, 220, 221)

Somali heritage parents in the UK (see Chapter 8) 156, 161ff

Patriarchy/patriarchal culture 6, 18, 48, 84, 294

African women seen as passive victims of 189

critiques of 7, 18

patriarchal social norms 186

Paulme, Denise 52

Personhood 72, 272, 277, 279

Pharaonic cut (also see Somaliland, SOFHA, Sudan) 92, 99, 100, 106, 114, 189, 193, 195, 196, 198, 200, 283

in modern Sudan 134, 283, 288, 289, 291, 292, 294

moves away from (Somaliland) 99, 105, 111, 113, 117

1946 ban in Northern Sudan 291, 292

vernacular terms for (Somaliland) 111

Plan International (NGO) 79

Pokot people (Kenya) 270, 275 n. 17

Plastic surgeons (also see genital cosmetic surgery aka FGCP, and Chapter 10)

ISAPS (International Society of Aesthetic Plastic Surgery) 188

and rising trend in FGCP 188

Police and policing

UK (see Chapter 8) 159, 161, 163, 165, 166

pre-emptive policing 166

and self-policing 162, 165

Kenya 67, 68, 211, 233, 236, 237

cross-border 241

Policy makers and policy making 8, 13, 20, 23, 37, 44, 94, 143, 210, 251, 257

Population Council-Kenya (NGO) 108, 247–8, 250

Pornography (and promotion of false norms) 188, 199

Poverty 20, 21, 56, 67, 128, 170, 285, 286

Power 6, 7, 17, 56, 59, 83, 92, 93, 94, 101, 104, 175 (for religious leaders, see Chapter 4)

coloniality of 155 n.1; imperial power 18

cultural 56

dynamics 29, 62, 63, 79, 80, 91, 93, 94

power relations and structures 18, 22, 43, 44, 58, 80, 91, 92, 94, 162, 252

state power 63, 64, 65, 77

men’s power over women’s bodies 6

Practitioners (also see health workers/professionals)

Prolongeau, Hubert 174, 177, 179, 186

Prosecutions (for FGM/C see Chapter 11, and individual countries and country studies)

Public declarations to end FGM/C 91, 215, 215 n.10, 267, 267 n. 5 and 6, 274, 274 n.16, 279

by religious and other leaders 77, 91

criticism of their effectiveness 77, 267

and Tostan (Senegal) 267 n.5

Public Policy Advisory Network on Female Genital Surgeries in Africa 95

Racism (for racism and racial profiling in UK see Chapter 8) 47, 48, 53, 161, 188, 189

FGM (as a term) considered racist 47

institutionalised racism (in UK anti-FGM/C laws) 170

‘racist logic’ 156

Reinfibulation 9, 134

Religion (also see churches, denominations, missionaries, Christianity, Islam, Chapter 4 passim) 21, 151

African traditional religion and animism 81, 84

belief that FGM/C is required by 21, 77, 78, 85

disentangling beliefs from FGM/C 77–8

no major religion is linked to FGM/C 21

bridges between the sacred and the secular 94

correlation between belief that FGM/C is a religious requirement and choice to continue it 84, 87, 94

definitions of 81

faith-based organisations 80

influence of (see Chapter 4 passim)

Judeo-Christian framing of 81

power dynamics (local, in Africa) 80

religious discourse around FGM/C 82

religious identity in Africa 81

blurred lines between types of 89

collective identity 81

religious influence on socio-legal norms and frameworks 26, 78–9, 80, 81

and role in decision making 94

research on links between belief and FGM/C 78

theological arguments delinking Islam from FGM/C 92

and cultural and social identity 77, 79

and cultural beliefs and practices 80

and cultural expectations 80

and legal norms 77, 79, 81

and patriarchy/patriarchal beliefs 78, 84

Religious leaders (also see named religions, Chapter 4 passim) 12, 26, 51, 80, 81, 83, 151

approach and attitudes to FGM/C (Islamic and Christian) 79, 113, 116

as change agents 51, 151

as custodians of culture 92

as stakeholders 77, 79, 91, 92, 102, 249

definition of 91

engagement with 12, 37, 51, 77, 79, 91, 92–3, 94, 100, 101, 109, 112, 126, 134, 151, 213, 222–3, 261, 295

legitimacy of 80–1

public declarations by 26, 77, 91

pushback/opposition to change and laws 82, 221

role in abandonment 116

types of 80

Religious scholars and texts, holy books 78, 79, 81, 83, 91, 92

Reproduction (women’s, also see under women) 7, 48, 52

colonial interest in African reproduction and fertility 8, 15–16

reproductive health and rights 50, 51, 81, 213, 219 n. 13, 220, 232, 249, 250, 250 n.4, 251, 252, 261, 290

Rescue (girls from FGM/C) and refuges 12, 225, 271 n.10

critiques of 234–5

and problems around family reintegration 234–5

Research (also see data, methodology, specific studies, Chapters 3, 4, 5, 6, 7, 8, 10, 13, 14 in particular passim) 9, 10, 1, 22, 23, 34–5, 36, 38, 52, 53, 57, 65, 68, 78, 80, 94, 97, 98, 101, 102, 103, 104, 106, 108, 109, 110, 116, 117, 118, 133, 153, 155, 156, 158

Bristol research (see Bristol entry)

community based 97, 100, 117, and Chapter 5 passim

community led 11, and owned 118

evidence based 17

fatigue with 295

funding/budgets 39, 118, 262, 263

future directions 73, 114, 282, 294–5

impacts of 109–15, 116

limitations of 104–5

Participatory Community-based Research (PCBR, see methodology)

power hierarchies in research processes 162

and training 35, 102, 103–4, 105, 118

and ethical practices 11, 63, 103, 105, 145, 294

with communities 97 (also see Chapters 5 and 8 passim)

Resistance (to laws and change) 37, 51, 59, 120, 145, 207, 213, 215, 235, 237, 239, 240, 252, 254–5, 269, 270, 284 (also see Chapter 11 passim)

Reverse clitoridectomy (aka clitoral reconstruction, reconstructive genital surgery; also see Pierre Foldes, O’Dey) 153, 171, 172, 173, 186 (and Chapter 9 passim)

call for more research into 186

counselling (psychosexual) 172, 182

effects of 174

‘erotic options’ (renewed after surgery) 75

medical professionals’ scepticism of 172

motivations of African diaspora women seeking surgery 172

pain of 182

surgery (how it is done) 178, 183

origins of surgical technique 174

traditionalists’ (African) opposition to 176–7

Women Safe & Children (Paris, France, aka Institut en santé Génésique) 175

and speak-outs 178 n.11, 180, 184

women’s agency and empowerment 185

women’s disappointment in 181–2

women’s testimony (African diaspora) 177–83, 184

and gynaecologists 177–8

and sexologists’ views (see under sexuality)

and Khady memoir 171 n.1, 176

and UNCUT/VOICES Press 171, 171 n.1

Rites/ritual 6, 62, 65, 73, 14, 166, 243, 261, 266, 267, 272, 273, 274, 275, 277, 280

criticism of the term ‘ritual’ 176

FGM/C framed as cultural ritual 193

FGM/C seen as ‘ritual abuse’ 185

ritual efficacy 274–6, 279

transformative function of traditional initiation ritual 243, 274–6

Rites of passage (also see traditional initiation rituals, Alternative Rites of Passage) 52, 17, 137, 240, 246, 273 n. 14, 277, 281, 283

Loita Rite of Passage (Kenya) 267 n.6

Royal Academy of Medicine (London) 173

Rwanda

and gukuna labial stretching 57, 58

Saleema Initiative (Sudan) 90, 137–8, 284, 285, 295

evaluation of 138

Samburu people (Kenya) 272, 274

FGM/C prevalence 238, 246

Mepukori study of Amref ARP (2016) 260

Saudi Arabia

religious scholars 92

‘Saved’ trope 57, 274

Schools (also see teachers, SOFHA research) 23, 286, 287

anti-FGM/C curricula (or attempts to introduce it) 109, 115, 256, 261

removal of pupils by parents (suspected of FGM/C, UK) 163

role of 102, 106, 105, 109, 115, 162 (UK), 163 (UK), 165 (UK)

school drop-out and retention 247, 248, 251, 258

school referrals (UK) 162

Senegal (also see Tostan) 85, 86–7, 177, 183, 184, 205, 212–13, 219 n.13, 267, 285

anti-FGM/C laws 213, 214–15, 217. 219

campaigns against FGM/C (see case study Chapter 11)

Enda Graf Sahel 212

Ministry of Family Affairs (and action plan) 213

Ministry of Women, Children and the Family 212

National Committee for the Abandonment of Harmful Practices Affecting Women and Children 212

Women’s Association for Strengthening the Struggle Against Traditional Practices 212

Sex reassignment surgeries 197, 229

Sexual and Reproductive Health and Rights (SRHR) 81, 249, 250, 250 n.4

Sexuality (and erotic pleasure) 7, 10, 45, 46, 47, 60 n. 2, 77, 111, 125 n.3, 134, 137, 179, 180, 182, 189, 250, 269, 294

African women’s erotic pleasure restored after reverse clitoridectomy 177, 179, 180–3

expectations of women’s sexuality 189

FGM/C as male control of women’s sexuality 182

rights to 7

women deprived of their rights to 47

and socio-cultural ideals 189

and sexual development 72

and sexual function 10, 195 (assumed to be impaired by FCGP)

and sexologist Catherine Solano 180

and sexologist Dr Frédérique Hédon 182

Shell-Duncan, Bettina 5, 6, 9, 213, 219, 270

Shweder, Richard 1, 6, 10, 281

Sierra Leone 15, 40, 85, 86–7, 89

and Bondo 12, 266 n.2, 284, 292, 293

and cross-border FGM/C 241

Social conventions (see social norms) 57

Social norms and FGM/C (also see Gerry Mackie) 7, 12, 13, 18, 28, 37, 77, 78, 80, 81, 84, 91, 137, 138, 145, 149, 150, 231, 233, 236, 249, 256, 257, 260, 265, 296

religiously-influenced norms 26, 77, 78, 79, 80, 81, 94, 138

social norms theory 12–14, 138, 260, 260 n.9, 265

Social reproduction 272

Somali people 83, 90, 91, 239, 283 (also see Chapter 8 for Somali heritage community in the UK)

diaspora (other than UK) 190, 227

FGM/C prevalence 40 (in Somalia), 238 (in Kenya), 239, 245

resistance of communities (in Kenya) 236

Somali Parents Against Stigmatisation (UK) 161

Somali Muslim scholars 83, 91

terms for FGM/C 111

women (and childbirth) 227–8

Somalia 5, 40, 82, 83, 85, 86–7, 89, 90, 99, 138

cross-border FGM/C 216, 241

Somali Health and Demographic Surveys 85, 99

and prevalence data for Somaliland 99, 163 n.13

Somaliland (also see SOFHA) 4, 9, 82, 97, 99, 100, 101, 102, 103, and Chapter 5 passim

anti-FGM/C policy (2024) 100

approaches to ending FGM/C 100

change/s

in attitudes to cutting 108, 111,112

in policy making 109

supporting change towards abandonment 112

fatwa (2018) 82, 82 n. 4, 83, 109, 116, 151

FGM/C prevalence data 99

government ministries 103, 105, 109, 110, 113, 115, 116

medicalisation (rise in) 105–6

motivation to perform FGM/C 111–12

Somaliland National Youth Organisation 115

Somaliland Nursing and Midwifery Association 113

types of cut 99, 110, 111, 114, 116

Somaliland Family Health Association (SOFHA, a CSO) (and its research study. Also see PCBR under methodology) 97, 99, 100, 101, and Chapter 5 passim. Much of the following refers to research by SOFHA and partners

attitudes to abandonment

key stakeholders including religious leaders 101, 106, 116, 166

health practitioners 102, 106–7, 113, 114

young men 106

teachers 101, 102, 106, 114, 115

women 106, 114

baseline findings 105–7

benefits for research participants 117

dissemination of findings 108–9

impact 109–10, 111, 116–18

research survey questions 103

and self-questioning by research team 110

decision making 117

dilemmas of health practitioners 114

donor-driven agendas 112

change

communities’ willingness to 117

direction of 117

men’s flexible attitudes to 112

in type of cut (move away from pharaonic) 99, 105

education/schools 106, 107

curriculum materials on FGM/C 109, 115

redefining role of schools and teachers 115

engagement with stakeholders including parents and youth 100, 101, 108, 109, 115

influencer groups (redefining role of) 112

evidence-based approaches 101

harms and harm reduction 106, 109, 112, 115

knowledge

co-created (via research) 101

knowledge-sharing workshops 108

locally owned 101

maternal health (FGM/C a key aspect of) 100

medicalisation 106–7, 111–13

percentage of FGM/C done by health practitioners 112–13

redefining the role of health practitioners 112–13

role of health practitioners in abandonment 102, 107

midwives 106–7; and TBAs 107

programmatic changes post research 112–14

research limitations 104–5

social pressures (competing) 110

and Amal Ahmed xii, 99, 102, 117

and CSOs 100, 101, 106, 108, 108, 108 n.3, 110, 111, 113, 114, 116

and role of young men in abandonment 102

and vernacular terminology 111

Sow, Mariame Racine 183–4

Stakeholders (also see book passim, country and research entries; for faith leaders, see Chapter 4 in particular) 17, 90, 97, 100, 101, 102, 103, 108, 109, 110, 113, 118, 121, 126, 161, 209, 218, 220, 243, 246 n.2, 263, 264, 299

Status (also see women) 52, 58, 252, 254, 277, 279

girls’ status 52, 252, 254, 268 n 8, 272, 276–7, 279, 285

role of FGM/C in upgrading women and girls 268 n. 8, 272, 277, 285

and uncut girls’ ‘pariah’ status 234

Symbolism

of the clitoris in Western discourse 194

Symbolic

associations of signs 275

public declarations seen as symbolic 274 n.16

ritual as symbolic acts 54

symbolic local conceptions 46

symbolic pricking (of clitoral hood) 190, 191, 192

transformation of boys’ bodies through circumcision 64

Sudan (also see separate Sudan research entry below)

Ahfad University 290, 290 n.3

anti-FGM/C campaigns 90, 134, 137–8

Saleema Initiative 137–8, 284, 295

UNICEF 133 n.2, 135

FGM/C

age of (changes in) 135–6

factors that facilitate/sustain it 139–40, 141, 142

health risks 14, 135

prevalence (national) 133, 134, 144

types 134, 135, 137

women’s reasons for continuing 133–4

change/s

behaviour 133, 134

in type practised 137

drivers of 135, 137, 141, 146, 291 (see Alassad study)

historical overview of shifts in practice 135

civil war and impact on civilians 287

colonial Northern Sudan 190

ban on pharaonic cut (1946), triggering revolt 284

medical missionaries 16

(UK) parliamentary campaign and debates on infibulation 16

cultural and religious norms 135

GRACe (Gender and Reproductive Health and Rights Research and Awareness Center) 290, 291

harm/s (growing awareness of) 136, 137

harm reduction 136, 137

Islam/religion

religious beliefs 134

religious leaders 134

sunnah believed to be part of Islamic tradition 137

legislation

national 138–9

state level 139

legal and policy frameworks 138–9

medicalisation (rise of) 136, 137

drivers of 287–8

institutional complicity in 136

and involvement of health practitioners 136, 137

and midwives 287–9, 292, 294

MICS data 136

National Council for Child Welfare 137

Sudan research (by Nada Alassad, author of Chapter 7) 98, 133–50

decision making 143–4

influence of communities, community leaders, peers, ‘superiors’ 143, 144, 145, 149

social norms and peer pressure 145

Decomposed Theory of Planned Behavior (DTBB) 140–3

findings 144–6

gaps in delivery and engagement 134

hypotheses 142, 143

medicalisation (and involvement of health professionals) 136

models (theoretical) 133 n.1, 139–44, 146–8

model findings 149–50

Structural Equation Modelling (SEM) 146–8

and how it reveals drivers of behaviour change 146

participants’ profiles 144–6

relationship between behavioural intention and actual behaviour 144

roadmap for change 143, 150

shift in type of FGM/C 135

social and subjective norms 137, 138, 141, 142, 143, 144, 145, 149

Sunnah (also see Somaliland, SOFHA, Sudan) 83, 90, 99, 106, 107, 110, 112, 113, 135, 151, 190, 192, 286, 289, 292

different types of 111, 112, 292

vernacular terms for types of cut (Somali) 111

Sustainable Development Goals (SDGs) 14, 14 n.7, 41, 120

SDG 5.3 (elimination of harmful practices) 34, 35, 120, 264

Tasaru Ntomonok Initiative (NGO, Kenya) 270 n.9, 271 n.10

Tanzania 4, 14, 85, 86, 87, 88, 90, 216, 248, 256, 266, 267 n.4

cross-border FGM/C 216, 241, 248

Teachers (also see engagement with schools, references to teachers in country entries) 12, 35, 93, 101, 102, 106, 112, 114, 115, 116, 122, 163, 249, 256, 289, 295

as change agents 115

found not to be 106

attitudes of 102, 106, 116, 289

engagement with 12, 101, 112, 114, 249, 256 (and book passim)

redefining the role of (Somaliland) 115

in UK 163

Terminology (also see WHO types) 2–3, 4–5, 11, 21–2, 44, 103, 138, 176, 177 n. 10, 200

debate around 21–2, 282–3

origins of the term ‘mutilation’ 3 n.2, 46

vernacular terms 2, 4, 111, 276 n.21

views of the term ‘mutilation’ 2–3, 176, 177 n.10

Tharaka people (Kenya)

and earliest Alternative Rites of Passage in Kenya 247

Theology (see Chapter 4 passim)

of bodily integrity 90

public theology 82, 83, 94

Thiam, Awa 47–8

Thomas, Lynn M. 16 n.9

Togo 85

data on 86–7, 89

Tostan (NGO, Senegal) 13 n.6, 90, 212, 267, 267 n.5, 286

Tradition/s (also see culture, cultural) 7, 31, 43, 44, 46, 47, 49, 51, 52, 54, 55, 57, 71, 78, 82, 84, 91, 99, 137, 176, 192, 196, 199, 276–8, 282

traditional cultural practices (see Chapter 2 for discussion of these and harmful practices)

adherence to (Maasai) 276–8

Traditional Birth Attendants (TBAs) (also see circumcisers, aka cutters) 4, 9, 12, 45, 82, 100, 107, 122, 136, 196, 212 n. 6, 216, 219, 221, 223, 231, 237, 241, 249, 250, 252, 254, 292

alternative income generation for 250

calls for training and vetting 229; health training 212 n.6

reassigned as birth companions 250

and social status 254

Trauma/traumatisation 38, 162, 172, 173, 174, 178, 181, 184

impact of (work of Bessel van der Kolk) 172–3

and retraumatisation 162,162 n.9, 164, 166, 168

Uganda

cross-border FGM/C 216, 241

United Kingdom (UK) (government ministries, departments etc. are grouped under government, including those cited in the Bristol study; see Chapter 8 passim. For media, see separate media entry)

asylum claims (related to FGM/C) 158, 209

British Paediatric Surveillance Unit 159

British Society for Paediatric and Adolescent Gynaecology 159

legislation

The Female Genital Mutilation Act 2003 157

The Prohibition of Female Circumcision Act 1985 157

Serious Crime Act 2015 157

and convictions 155, 157/8

and mandatory reporting 157, 162

legislative and policy responses to FGM/C 157

police and policing 159, 162, 163, 165, 166

prosecutions for FGM/C 154, 162

attempted prosecution (2018) 160–1

UK Government 169

Crown Prosecution Service (CPS) 159

data on FGM/C prevalence 156

Department for Education 159

Department of Health 159 n.3

Home Office 159

Ministry of Justice 159

NHS (National Health Service) 158/9

NHS FGM Enhanced Dataset 159, 159 n.3

United Nations (also see Sustainable Development Goals, Human Rights Council) 4, 153, 155, 209

Office of the UN High Commissioner for Human Rights (OHCHR) 90

UN Commission on Human Rights (and resolutions) 33

UN Commission on the Status of Women 32

UN Convention on the Rights of the Child (CRC, 1989) 30, 208, 210

Joint General Recommendation No. 31 (2019) 50

UN Decade of Women 5, 45

UN Economic and Social Council 44

UN Human Rights Council Resolution 38/6 (2018) 33, 90

UN International Women’s Year 145

UN General Assembly 30, 31, 33, 49, 50

Declaration on the Elimination of Violence Against Women (1993) 31, 40, 50

Resolution 38/6 on the elimination of FGM 90

Resolution 34/180 (1979, which led to CEDAW) 49

UNFPA 5, 108, 241

UNFPA-UNICEF Joint Programme on the Elimination of FGM 5, 33, 34, 90, 150, 211, 213, 214, 267 n.6, 274, 274 n.16

UNICEF 4, 5, 7, 13, 35, 38, 44, 78, 120, 131, 133, 133 n. 2, 135, 137, 158, 163 n. 13, 217, 239, 295

and Saleema Initiative (Sudan) 137

Universal Declaration of Human Rights (1948) 38, 208

United States

anti-FGM/C laws 36

End FGM US movement 176

law enforcement (1980s) 191

legal cases 11, 283 n.1

US surgeons and clitoral restoration 185

and medicalised neonatal male circumcision 5, 10

and highest male circumcision rate globally 226

Vagina/vaginal 24, 178, 183, 184, 188, 189, 228

forced opening of 134

vaginal rejuvenation 188

Vagengers, The (UK-based charity) 175, 176 n. 8

and Hoda Ali 175

VAW and VAWG (Violence against Women, Violence Against Women and Girls; also see violence)

VAW 27, 175, 289

VAWG 63

Violence (also see VAW, VAWG; this entry includes all gender-based violence and UN/other protocols or laws against it) 7, 18, 21, 25, 27, 29, 30, 31, 32, 33, 40, 49 n. 9, 55, 57, 58, 59, 63, 82, 155, 175, 208, 208 n. 1, 219, 228, 239, 246, 289

against boys around male circumcision 25, 60, 64, 65, 66, 67, 68, 71, 74, 75

Voluntary Medical Male Circumcision (VMMC) (also see male circumcision) 61, 62 n.4, 63, 65, 74, 226–7

and HIV prevention 65, 226–7

Vulva 171, 173, 175, 183, 186, 188

men’s fear of its power 175

Warriors/warriorhood

Kuria 233

Maasai warriors and CLARP (Kenya) 249, 252

Wassu-UAB Foundation 35

World Bank 226

World Food Programme (WFP) 128, 129

World Health Organization (WHO) 3, 5, 9, 32, 35, 43, 44, 45, 50, 57, 61, 63, 65, 69, 72, 74, 75, 113, 114, 167

FGM/C types (also see textbox, 24) 4, 29, 43, 56, 82, 83, 99, 120, 121, 121 n.2, 134, 151, 159, 189, 193, 194, 290

WHO definition of FGM/C 3, 9 (medicalised), 193

definitions challenged by emerging practices 153–4

and critiques of WHO position 11, 24

contradictory position on FGM/C and FGCP 24, 188–9, 296

contradictory position on FGM/C and male circumcision 72, 229

initial avoidance of FGM/C 5, 30, 44

policies on male circumcision 69, 72, 226

toolkit for training health workers (2022) 9

also see WHO Seminar on Traditional Practices (1979, Khartoum) 46, 212

Women (also see VAWG and VAW, Chapter 2 passim, bodies, feminism, and most chapters) 1, 2, 3, 4, 5, 6, 8, 9, 11, 12, 14, 17, 18, 19, 20, 21, 25, 27, 29, 30, 31, 32, 33, 34, 37, 38, 40, 41, 43, 44, 45, 46, 47, 49, 50, 52, 54, 56, 59, 63, 66, 68, 69, 73, 74, 75, 82, 85, 86, 87, 90, 95, 97, 98, 99, 100, 101, 102, 104, 105

acting politically as mothers 62–3, 69, 73–4

African 8, 46, 47, 48, 49, 52, and book passim

double burden faced by 47

stereotypical representations of 52

agency of 29, 49, 129, 153, 157, 185, 186, 192, 194

autonomy of 11, 17, 20, 29, 55, 57, 95, 191, 194, 195, 196, 197, 202, 221, 232, 270, 293

discrimination against 3, 47, 50 (and the book passim)

empowerment of 6, 14 n.7, 17, 29, 32, 49, 58, 127, 134, 185, 270, 285

fertility and reproduction (colonial interest in) 8, 15–16, 72, 73

practices that prevent women controlling their fertility 49

lived experience of circumcised women 227

marriageability 111, 199, 247, 288, 290

oppression of 6, 45, 46, 47, 270, 287

rights of (also see Chapter 1, and human rights generally) 6, 7, 27, 29, 30, 32, 34, 35, 40, 41, 57, 196, 252; the book passim

rights to bodily integrity 18

rights to choose 18, 197, 228, 284

sexuality (see sexuality entry above)

status (including upgrading) 52, 158, 252, 254, 277, 279

stigmatisation and (re)victimisation of 38, 49, 223

views of (essentialist) 52, 54, 57, 58

views of white Western women vs. African women 194

infantilisation of African women in Western discourse 197

violence against (see above under violence, also VAW)

voices of (this includes community voices) 8, 18, 22, 23, 76, 111

vulnerability of 74, 235 (legal), 246 (Maasai girls and women)

and childbirth 134 (also see separate childbirth entry)

and FGM/C global prevalence 1, 38

and inequality 47, 48

and male control of sexuality 6, 46, 56, 135, 189

and reproductive health and rights (also see reproduction) 7, 35, 50, 51, 81, 213, 220, 232, 249, 250, 250 n.4, 251, 252, 261, 290

as food providers (after boys’ circumcision, see Chapter 3)

as ‘victims of tradition’ 46

Women Safe & Children, Paris (see Institut en santé génésique, and Foldes)

Yemen 5, 9

Youth and engagement with youth (also see girls, boys, much of Chapter 3) 12, 13, 100, 109, 115, 135, 250, 255, 261

critiques of 204, 283, 296

definition 204

International Day of Zero Tolerance (UN) 14, 33

role in driving FGM/C underground 191

textbox 204

and the WHO 190–1