Comparing FGM and MGM

If a person does a search on Female Genital Mutilation (FGM), vast amounts of information will appear about how the practice is a form of gender-based violence against females and the reader will be presented with information about the harmful effects of the procedure. One can see there is, for the most part, moral outrage that the practice exists, where the concept of autonomy drives beliefs about why the practice is unacceptable to force on a female child.  Claims are also made that the imposition is indefensible because the practice is said to ‘have no health benefits,’ (a debated claim even in the academic literature)i and that the practice is not religiously justified (a claim that has also been contested in scholarly publications).ii  For a variety of reasons and excuse, most of the world holds a negative view of FGM.iii  This is an effect of the circumstance that “western discourse about female genital circumcision (SIC) has been shaped exclusively by its opponents.”  Interestingly, the same outlets, whether media or official bodies, that condemn FGM for various reasons, claim that MGM is a religious practice because some ‘religious’ texts are perceived to prescribe it iv and as a possible means to allowing MGM, supporters also conflate hotly debated claimed potential medical benefits of the imposition.v  Furthermore, the practice, as it is imposed on males, is almost never called Male Genital Mutilation (MGM) in any official capacity, but is instead, referred to as male circumcision.  Although these deceptive claims are maintained by the WHO, they never-the-less, show a controversial double standard, to which, the WHO has received considerable criticism.vi  

 It appears to be evident that those opposed only to FGM and not MGM have made deliberate attempt to hinder the association of the practice of FGM to its male counterpart (MGM).  Anti-FGM campaigns do so by presenting sensationalistic claims of harmsvii and present the practice only as it is done where the most severe types are imposed in Africa (Sudan and Somalia), which represents a minority of the cases worldwide. When one looks at and compares the actual practices, “there are good reasons to consider male and female circumcision together.”viii  Yet, supporters of Male Genital Mutilation have had the exclusive dominant voice in international organizations regarding what is presented to the public and what is pushed as acceptable regarding modifications of genitals.  Such influences have been presented as the voice of American culture and Medicine which has worryingly influenced the World Health Organization.  For a more in depth understanding of these points, one can read a chapter in the book “Systemic Terrorism – Circumcision,” entitled, 

The AAP, PEPFAR and the CDC – Willful Ignorance of Culturally Biased Advocates of Male Genital Mutilation (“Circumcision”) or Something Else  

As a result of these ideas being promoted, “there is a false belief in some societies today, that Female Genital Mutilation (FGM) and Male Genital Mutilation (MGM) cannot be compared,”ix more specifically, they cannot be viewed as equivalent in terms of complications, risks and harm.  One can link to a retort made by a physician who wrote a rapid response article claiming this very thing.  If the reader so desires, they can link to a critique to his publication entitled: 

A Retort to “male circumcision is not comparable to female genital mutilation” 

What is genital mutilation? 

It can be said that there is inconsistency between what the general public believes the definition of FGM to be and what the official definition is of FGM.  This has to do with what the actual definition of FGM is as presented by the WHO and what is considered prosecutable if imposed on a minor female child versus the information the general public has been presented with by various media sources.  Various media sources tend to show the most extreme forms of FGM, while ignoring that even the most minor forms can result in prosecution under most Western legal systems.  Thus, the impression is given that all of the practices that are officially and legally defined as FGM, are inherently more severe than MGM, which is factually inaccurate.  Additionally, when considering similar genital mutilation imposed on males, no equivalent sympathies are presented to the public for males having MGM imposed on their person via media, which parallels legislative realities in the countries with inconsistent policies on genital mutilation based on gender.  Despite the inconsistencies in how the practices actually occur versus what is officially labelled as genital mutilation, it is important to note that the official description of genital mutilation, as presented by the WHO, generally describes any cutting, pricking or other alterations of the female genitalia.  The obvious important point here is that what constitutes genital mutilation is based more on gender than severity.  This should lead the reader to question where the WHO stands on other mutilative practices, such as harmful alterations being imposed on intersex and male children.  Due to the unique history of intersex genital mutilation, a separate section will address this topic.  To access this, the reader can link to:  

Intersex Genital Mutilation 

Please be aware that there will be some overlap between this section and the contents contained in the intersex genital mutilation section. 

Social Attitudes surrounding Views on FGM and MGM at the Level of the general Public  

Although social attitudes about FGM and MGM have been shaped by political powers through systemic policies as well as through what is presented in the media of various countries, social attitudes about FGM and MGM cannot be fully explained by what various international bodies present.  Cultures, or at least a number of those in cultures that practice FGM consider media campaigns to be propaganda designed to impose Western Cultural Imperialism through attempts at eradicating what they believe to be a valuable or even treasured practice.  A number of publications have addressed the challenges present in attempting to eradicate FGM.x  At the same time, where MGM is being pushed where it has never been practiced before, members of such civilizations have shown their disdain for such efforts (such as in Denmark, Iceland, etc.)  However, as stated above, in cultures where MGM is practiced, it is difficult to deny that the media and systemic efforts are in place to push the continuation of the practice.  The US is such a place, where massive media campaigns and cultural bias in established medical bodies have, at the very least, established the practice and can also be seen as the driving force behind the high circumcision rates that remain in such environments.  In addition to systemic institutions influencing information outlets to sway or reinforce desired social/societal views on both FGM and MGM in opposite directions, there is another related effect that can at least be said to have been partially, if not substantially born from such measures to sway public opinion, that being myths.  There are many myths that exist surrounding both FGM and MGM.  For more information on myths about genital mutilation, the reader can link to:  

Myths about MGM, AKA male ‘circumcision’ 

Myths about FGM and MGM 

If one reads either or both of the above links, one can see that myths not only exist about MGM, many myths relating to MGM are those making comparisons to FGM which are designed to trivialize MGM. 

Demographics of Genital Mutilation  

One aspect of genital mutilation that goes unacknowledged by those who exclusively condemn FGM and not MGM is that all cultures in the world which commonly commit FGM, also commit MGM.  “(V)irtually every society that does practice customary female genital modification also practices customary male genital modification.” xi   Meaning, there appear to be zero cultures or societies where FGM is practiced without MGM.  Therefore, worldwide prevalence of Male genital mutilation is much higher than it is for female genital mutilation, with about 30% to one third of the entire world’s males having been victims of MGM and about 2.5% of the entire world’s females having been victims of FGM.   MGM is more predominant in Islamic societies, however, whether these rates are explained by culture or religion is controversial.  Regardless, the practice is established in Muslim countries. 

FGM & MGM rates and Regions– 

There further appears to be a relationship between high rates of MGM and FGM (Somalia, Ethiopia, Egypt), although there are cultures with high rates of MGM that do not practice or have low rates of FGM (Afghanistan, Israel, the Philippines).  It is also important to note, that countries known for having a majority MGM, have significant amounts of their citizenry who have also begun ‘opting’ for adult female ‘circumcisions’ (Turkey and to an extent, the US).  Additionally, the most extreme cases of FGM are practiced in societies where the rate of FGM is high (in Sudan and Somalia).  However, less severe forms are also practiced in other regions where FGM and MGM rates are also high (among Malaysian Muslims).  Furthermore, there are other regions where both FGM and MGM are practiced, where MGM rates are high and FGM rates are quite a bit lower (Yemen, Indonesia).  Based on this, there is no uniform system of practicing MGM or FGM and MGM. 

Displaying the Varying Types of FGM and MGM  

In a number of publications, it is stated that one of the reasons for the lack of acceptance of FGM, has to do with the amount of variation in practices of FGM in comparison to MGM, however, this idea likely has more to do with the lack of recognition of the more severe forms of MGM than it has to do with the actual variety of types of MGM that are practiced.  Below is a comparison of the varying types of FGM and MGM that are imposed, primarily on children, in various parts of the world.  Please also note that the WHO does not make a distinction in their description of the varying types of FGM in regard to what is practiced in hospitals in the West and those which are practiced under unsanitary conditions.xii  Below is a description of the various types (based on severity of tissue altered) of FGM and MGM with descriptions of FGM on the left and MGM in the right.  Note:  These descriptions entail Severity, not whether the environment or instruments are sterile or not.  At the top are the least invasive, while those at the bottom are the most severe.  Those types highlighted in gray represent those which have been labelled as criminal offenses in Western Countries, if imposed on children without a pressing medical indication.xiii 

 

 

Type of FGM and MGM 

Type  Female	Name	Description	Type  Male	Name	Description
Type 4        Type 1A        Type 1B          Type 2A	Ritual Nick        Hoodectomy        ’Clitorectomy’          Labiaplasty/’trimming’	Other ’alterations’- pricking, incising, scraping, and cauterization.xiv    “Removal of the prepuce/clitoral hood only.” xv    ”Removal of the clitoral glands with the prepuce/clitoral hood,”xvi       ”Removal of the labia minora only.”xvii		Circumcision (as Practiced by Jews in Ancient times)          Circumcision (as often practiced by Muslims)	Cutting off the foreskin that overhangs past the glands, leaving the skin covering the glands), typically does not result in obliterating the frenulum.      Obliteration of the foreskin (may include excision of the skin covering the glands, obliteration of the frenulum (the male G-spot), Meissner’s corpuscles,xviii causes the majority of the mobile skin to disappear.xix
				Circumcision (US practice and the modern Jewish form)	Peeling away, crushing and excision of the prepuce and skin covering the glands (  ), most often includes obliteration of the frenulum (the male G-spot), Meissner’s corpuscles, xx obliterates all the moving skin on the penis, severely altering form, function and appearance.xxi
Type 2B	Excision/Cliterectomy (with ’Labiacision’)	”Partial or total removal of the clitoral glands and the labia minora (prepuce/clitoral hood may be  affected).”xxii
Type2C	Excision/Cliterectomy (with ‘labiacision’ and labia majora excision)	“Partial or total removal of the glands, the labia minora and the labia majora (prepuce /clitoral hood may be affected).”xxiii
Type 3a                                  Type3b	Infibulation/Pharaonic Circumcision (with labia minora changes)             Perineplasty      Vaginal Rejuvenation/  The Husband Stitch          Infibulation (with labia majora changes)	”Removal and repositioning of the labia minora…with or without removal of the clitoral prepuce/clitoral hood or glands”xxiv      Tightening of the vaginal openingxxv     The narrowing of the vaginal wall and possibly opening (this may or may not include labiaplasty or hoodectomy)xxvi    “Removal and repositioning of the labia majora…with or without removal of the clitoral prepuce/clitoral hood”xxvii		Subincision	“Slicing open the urethral passage on the underside of the penis from the scrotum to the glans, often affecting urination as well as sexual function.” xxviii
				Penectomy      Castration	Partial or total removal of the penile shaft    Removal of the entire Penis and testicles –  (Most commonly done in gender-reassignments)

For a more in-depth description of the various forms of FGM, the reader can link to: https://mapfgm.eu/wp-content/uploads/2017/04/Guia-Ingles.pdf xxix 

 

Notice, there are no WHO classifications to differentiate the various types of MGM as there are for FGM.  To do so, in any official capacity would mean that the WHO would have to acknowledge that at the very least, certain forms of MGM are not only more severe than certain forms of FGM, they would have to acknowledge that there are forms of MGM that are nearly as harmful as the most severe forms of FGM.xxx As has been acknowledged by academics for decades and was expressed in one publication by human rights scholars Darby and Svoboda: 

Selecting appropriate terminology to discuss genital alteration may at first appear a straightforward task, but, although much effort has gone into categorizing the types of female genital alteration, surgeries on the penis are classified by a single term.  Because MGA (SIC), even when non-therapeutic, is construed as harmless, there has been few efforts to provide MGA (SIC) with a(n) (official) classification system similar to that constructed for FGA (SIC), yet in principle such a project should be no more difficult than devising a scale to measure damage to female genitals.xxxi 

If one looks at the types of ‘FGM’ in regard to their severity, it is clear that there is no relationship between what is lawful in Western countries based on severity.  It seems clear that the relationship between what is ‘permissible’ and what is not, is based on gender and Western “exceptionalism.” xxxii  Meaning, those forms practiced in the West, which can be more radical than some forms of FGM practiced in African and Asian, such as vaginal rejuvenation.  In addition to the term ‘exceptionalism’ being meant sarcastically, given the myriad critiques by academics who have brought attention to the WHO for its embarrassing gender discrimination in their policy on genital mutilation, it is astounding that it is maintained by them.xxxiii  For more information about the WHO and their lack of consistency in applying human rights advocacy regarding people’s genitals, one can link to: 

The United Nations Clown Show About Human Rights and Genital Mutilation 

In addition to the obvious inconsistency regarding international policies of acceptability of genital mutilation practices based on harm and invasiveness, one thing lacking in the above graph is the issue of medicalization of such practices.  Much of the campaigns to end FGM and the belief that the practice is ‘barbaric’ are based more on ideas of medicalization and the potential complications that can arise when such procedures are not done in a sterile environment, than they have to do with the level of invasiveness.  In other words, although the above chart lists, to a degree, the harm based on amount of, what would be deemed valued tissue on a female, the issue of risk in regard to medicalization or non-medicalization of the practice is not included due to medicalization being relatively non-related to severity of the type and amount of tissue excised.  Although it would seem obvious that the more of an alteration, the greater the possibility of risk, particularly in a non-sterile environment, a separate list of risk is included based on above as well as additional types of MGM. 

 

Descriptions of Medicalized versus Non-Medical Mutilations.   

Clearly more severe forms of FGM performed in non-medicalized settings are considered more harmful, however, forms of MGM that are performed in non-sterile/non-medical environments, can be more dangerous than FGM 

FGM	Medicalized	Non-Medicalized	MGM	Medicalized	Non-Medicalized
Type 4          Types IA and IB                    Types 2A, 2B, 2C                          Types 3A, 3B	Can be done in a sterile or unsanitary environment      Increasingly                      Increasingly                            Increasingly	Can be done in a sterile or unsanitary environment         Decreasing – Can be done with broken glass, razor blades.                  Decreasing- Can be done with broken glass, razor blades.                          Decreasing – Can be done with broken glass, razor blades & sutured with thorns.	Male Circumcision          Metzitzah b’peh                      Xhosa South African Type      Subincision	Often          No                      Uncommon        No	Can be – When not done in a hospital or clinical setting, figure nails can be used to tear away the membrane of the attacked foreskin from the head of the penis.    Increasing – In addition to obliterating 1/3 or the penile skin as well as the frenulum, “fine-touch nerve receptors” and destroys sexual function by excising the only moving part of the penis.xxxiv  This particular ritual involves the ritual circumciser orally sucking on the open wound of the infant’s penis.        Often done with “spearheads and dirty knives.”xxxv      “…the bleeding is staunched with sand…the (slashed)…urethral wall is kept open with pieces of wood, bone, or clay.”xxxvi

 

  It is hoped that with the above information in mind, the reader can see that, “(m)ale and female circumcisions carried out under similar conditions” meaning in an unhygienic or a surgically sterile environment, “have similar rates of long-term and short term complications.” xxxvii  Which leads the reader to the next graph, showing the tremendous overlap in types of justifications used to promote FGM and MGM. 

 

Overlapping justifications used to perpetuate FGM and MGM within the communities that practice either MGM or Both FGM and MGM 

FGM	Justification/Excuse	Examples	MGM	Justifications/Excuses	Examples
	Social	Religious and cultural Motives, Mentioned or Required in some religious text,xxxviii Family Related justifications and pressures, xxxix belief that it ensures marriageability, will ostracize the female from her society,		Social	Religious and Cultural Motive, Mentioned or Required in some religious text,xl    Family Related justifications and pressures, belief one will have greater ease attaining a sex partner, not doing it will produce social ostracizing from peers,
	Aesthetic	Beautifying, xli		Aesthetic,	”Beautifying,”
	Medical	Hygiene,xlii reduced Sexual desire, lower risk of vaginal cancer and /HIV/AIDS and other STI’s, less nervous anxiety, fewer infections believed to be ‘caused’ by microbes in the folds of the vulva, protection against herpes and genital ulcers, xliii prevention of throat cancer for partners and reduced UTI’s, increases stimulation (hoodectomy)xliv reduces length of labor.		Medical	Cure for masturbation, xlv claims it reduces sexual pleasure, cervical cancer in women and penile cancer in men, Cures/prevents: UTI’s “epilepsy, paralysis, malnutrition, derangement of the digestive organ, chorea, convulsions, hysteria and other nervous disorders,” xlvi Claims to reduce HIV/AIDS and other STI’s,xlvii makes a man last longer, claims to increase stimulation.xlviii

 

As one can see from the above, there are a vast number of rationales for perpetuating genital mutilation.  More importantly, “The (main) reasons given for female circumcision in Africa and for routine male circumcision in the United States are essentially the same.” xlix  What is perplexing, is that surgical harms, complications, and risks are always lacking presence in such societies where trivializing the harm is a necessity for maintaining such practices.  Those who are conditioned to be fearful of social, divine, or anatomical reactions to being left intact will often not be informed about the consequences of the practice by those in authority who are also driven by the same and other such fears and/or motives.  To understand more about the psychological complexities of the denial that goes into being emersed in a culture that genitally mutilates, the reader can link to:   

Defense Mechanisms used to Push and Maintain Genital Mutilation 

For as many rationales exist, so to do the harms, surgical complications, and risks of the practice.  After having read a brief description of what each of the procedures that encompass FGM and MGM entail, it is important to know what surgical complications can arise, as well as long-term harms that can and do arise from these ‘procedures.’  Even in the most sterile environments, harms of MGM can and do occur.  It is an incontestable fact that medicalizing either FGM or MGM does NOT eliminate surgical complications.  Furthermore, the idea that medicalization somehow decreases surgical risks is highly debatable. l  It is more likely that in areas of the world, such as the US, under-reporting, when possible, is a very real motivator to attributing complications to other things or to ignore them completely.  This seems evident by the fact that A.) the AAP discussed how a ‘properly performed’ circumcision has not resulted in successful litigation and 2.) After decades of acknowledging the problem, no serious efforts have been made to find out the rates of complications, what to speak of the long-term harms that the policy board completely ignores.li  It is important to note that those who reported long-term harm from having MGM imposed on them in infancy and/or childhood had their ‘circumcisions’ listed as ‘performed properly.’lii 

 

 

Comparing Risks and Surgical Complications of FGM and MGM  

Due to the fact that the WHO does not make a distinction between variations in harms based on the severity of the different types of FGM, both FGM and MGM complications, risks and harms are presented to include all the Types of FGM and MGM.   

Consequences of:	FGM	MGM
Short-term surgical complications:	Pain, bleeding/hemorrhage, urinary retention, genital swelling, infection including but not limited to UTI, fever liii	Pain, bleeding/hemorrhage, necrosis, sepsis, meningitis, gangrene, choking, shock, coma,liv lv  infection including but not limited to UTI’s,lvi Genital Swelling.lvii
Long-Term surgical complications:	Obstetric complications, cysts, pain, death, UT complications (seem in more severe types), urethra damage, urine stricture, fistulae, vaginal calculi and dyspareunia apareunia,, “may reduce sexual sensation,” Haematocolpos dysmenorrhea, lviii UTI, bacterial vaginosis, infertility, dyspareunia, labor complications.lix Altered form and sexual function, vaginal lacerations (Type III).lx	Skin tags/scaring,lxi penile curvature (due to uneven foreskin removal), pitted glands, partial glands ablation, prominent/jagged scarring, amputation neuromas/complete amputation of the glans or the entire penis, herpes, gastric rupture, heart damage, fistulas, severely damaged frenulum, deformity, excessive keratinization, death, lxii lxiii pain,lxiv lxv meatal stenosis /scaring,lxvi lxvii desensitization,lxviii lxixaltered form and function.lxx lxxi
Negative psychological affect	psychological sequelae lxxii	psychological sequelae lxxiii lxxiv

  

Please note that a vast majority of the long-term complications of FGM are found in unsterile environments where the most severe type is practiced.  The fact that MGM practiced in sterile environments produces similar as well as identical harms should indicate that the severity of alteration is comparable, in at least many respects, to that of the more extreme cases of FGM. Complications, both long-term and short-term as well as the harms of the imposition, are a cost to the person the practice is being inflicted.  It is not likely to surprise the reader that the cost of genital mutilation to the individual has been a hotly debated topic.  For more information on this, one can link to:
 

The Cost of Genital Mutilation: the Etherical, Practical, Social, Rights, Rites and Tangible  

Overall, the link discusses what is lost to genital mutilation based on a variety of factors, as one can see from the title of the link, those include a variety of considerations such as spiritual, practical, social, tangible, and rights versus rites benefits and harms.  To understand why this is a hotly debated topic, one can link to:  

Mutilation or Circumcision – He Who Screams loudest and in the rite way gets the Voice 

 

Legal Issues with Gender Inconsistencies- 

Given the tremendous overlap between FGM and MGM regarding justifications, pressures, complications and harms, that can and are effects of both FGM and MGM, it has become a problem in Western countries to maintain legislation criminalizing the practices of genital mutilation based on gender.  Given that virtually all Western countries have some form of equal protection or gender equality clauses in their legal systems, the possibility of maintaining gender-discriminatory statutes is practically unrealistic.  After the institution of the anti-FGM legislation in 1996, Dena Davis published an article entitled, “Male and Female Genital Alteration: A Collision Course with the Law?,” lxxv the author discusses the legal issues with this gender double standard.  As many are aware, this theoretical concern was made a reality two decades later when a practicing US physician was indicted for FGM charges which later resulted in the dismissal of the FGM statute.  For a more in-depth understanding of the Case and what lead to the dismissal of the charges, the reader can link to: 

The Michigan FGM case and the ‘Constitutional Problem’ of Child Genital Mutilation  

If one reads the above article, the legal decisionlxxvi or secondary academic publication of the decision lxxvii or publications making references to the decision, lxxviii lxxix it seems clear that the gendered nature of the legislation has at least something to do with why it was struck down.  This has lead other academic scholars to begin defending so-called more minor form of FGM.  For example, Jewish as well as Muslims scholars have defended medicalizing FGM in the West.lxxx  For more information on who is promoting genital mutilation, one can link to: 

The Voice of Judeo-America – Who is Promoting MGM   

Although alarming that there are those Zealots of MGM wanting to legalize FGM to be able to ‘get away’ with MGM, their effort will neither be sustainable as the equal protection clause as it relates to MGM does not only have to do with gender. Equal protection laws encompass beliefs, gender age and more.  The idea of parental consent being adequate to allow the imposition without an immediate pressing medical need has been presented to be a legal fiction.  Even prior to the FGM legislation, at least one Legal scholar has written about how MGM violates child protection laws. lxxxi  

 

Conclusion 

One can see that although great pains are taken in an attempt to differentiate FGM from MGM by conflating the effects of one while trivializing the effects of the other, there is tremendous overlap between the two practices both in terms of justifications, harms, complications and obstacles in stopping the practices.  Although one could argue that there are greater obstacles in eradicating MGM than FGM.