SoF-May2005
PDF Upload
Handbook of WMA Policies
World Medical Association ½ S-1993-02-2005
WMA STATEMENT
ON
FEMALE GENITAL MUTILATION
Adopted by the 45th
World Medical Assembly, Budapest, Hungary, October 1993
and editorially revised by the 170th
WMA Council Session, Divonne-les-Bains, France,
May 2005
PREAMBLE
Female genital mutilation (FGM) is a common practice in over thirty countries.
In many other countries the problem has arisen more recently due to the presence of ethnic
groups from countries in which FGM is common practice, including immigrants and refu-
gees who fled from hunger and war.
Because of its impact on the physical and mental health of women and children, FGM is a
matter of concern to physicians. Physicians worldwide are confronted with the effects of
this traditional practice. Sometimes they are asked to perform this mutilating procedure.
There are various forms of FGM. It can be a primary circumcision for young girls, usually
between 5 and 12 years of age, or a secondary circumcision, e.g., after childbirth. The ex-
tent of a primary circumcision may vary: from an incision in the foreskin of the clitoris up
to a pharaonic circumcision or infibulation removing the clitoris and labia minora and
stitching up the labia majora so that only a minimal opening remains to allow for urine and
menstrual blood.
Regardless of the extent of the circumcision, FGM affects the health of women and girls.
Research evidence shows the grave permanent damage to health. Acute complications of
FGM are: hemorrhage, infections, bleeding of adjacent organs, and excruciating pain.
Long-term complications include severe scarring, chronic infections, urologic and obste-
tric complications, and psychological and social problems. FGM has serious consequences
for sexuality and how it is experienced. There is a multiplicity of complications during
childbirth including expulsion disturbances, formation of fistulae, ruptures and inconti-
nence.
Even with the least drastic version of circumcision, complications and functional conse-
quences can occur, including the loss of all capacity for orgasm.
There are various reasons to explain the existence and continuation of the practice of
FGM: custom, tradition (preserving virginity of young girls and limiting the sexual ex-
pression of women) and social reasons. These reasons do not justify the considerable da-
mages to health.
S-1993-02-2005½ Divonne-les-Bains
Female Genital Mutilation
None of the major religions supports this practice. The current medical opinion is that FGM
is detrimental to the physical and mental health of girls and women. FGM is seen by many
as a form of oppression of women.
By and large there is a strong tendency to condemn FGM more overtly:
• There are active campaigns against the practice in Africa. Many African women
leaders as well as African heads of state have issued strong statements against the
practice.
• International agencies such as the World Health Organization, the United Nations
Commission on Human Rights and UNICEF have recommended that specific
measures be aimed at the eradication of FGM.
• Governments in several countries have developed legislation, such as prohibiting
FGM in their criminal codes.
RECOMMENDATIONS
1. Taking into account the psychological needs and ‘cultural identity’ of the people in-
volved, physicians should inform women, men and children about FGM and dis-
courage them from performing or promoting FGM. Physicians should integrate health
promotion and counselling against FGM into their work.
2. As a consequence, physicians should have adequate information and support for
doing so. Educational programmes concerning FGM should be expanded and/or
developed.
3. National Medical Associations should stimulate public and professional awareness of
the damaging effects of FGM.
4. National Medical Associations should stimulate governmental action in preventing the
practice of FGM.
5. National Medical Associations should cooperate in organising an appropriate preven-
tive and legal strategy when a child is at risk of undergoing FGM.
CONCLUSION
The World Medical Association condemns the practice of genital mutilation including the
circumcision of women and girls and condemns the participation of physicians in such
practices.