The Means of Reproduction: Sex, Power, and the Future of the World (22 page)

All these procedures tend to be performed in unsanitary conditions, without anesthesia, using knives, razors, or scissors. In some places, particularly Egypt, there have been efforts to medicalize the practice and have doctors or nurses, rather than midwives or barbers, perform it, which makes it safer but also, many feminists fear, even more entrenched. According to the World Health Organization between 100 million and 140 million women around the globe have undergone genital cutting. Each year around 3 million African girls are cut, almost half of them in Egypt and Ethiopia.
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Immigration has brought female circumcision to Western countries. According to the U.S. Department of Health and Human Services, as of 1990, 168,000 girls and women in the United States had either undergone circumcision or were at risk of being subjected to it, and it’s safe to assume that number has only grown in the ensuing years.
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Not surprisingly, the health consequences of genital cutting can be dire. According to the World Health Organization, immediate dangers include severe pain, shock, excessive bleeding, difficulty urinating, infection, psychological trauma, and even death. “Long-term consequences that have been documented include chronic pain, infections, cysts and abscesses, decreased sexual enjoyment, infertility, posttraumatic stress disorder, and dangers in childbirth,” WHO says. Those last dangers can be significant; in an extensive study they found that “deliveries to women who have undergone FGM are significantly more likely to be complicated by caesarean section, postpartum haemorrhage, episiotomy, extended maternal hospital stay, resuscitation of the infant, and inpatient perinatal death than deliveries to women who have not had FGM.”
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Female genital cutting, the study reported, was responsible for an additional one to two infant deaths per one hundred deliveries.
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The WHO’s statistical analysis has been challenged by opponents of the anticircumcision movement. In a dialogue on a
New York Times
science blog, the anthropologist Shweder, well known as a defender of cultural relativism, wrote, “[T]he harmful practice claim has been highly exaggerated and...many of the representations in the advocacy literature and the popular press are nearly as fanciful as they are nightmarish.” A close, critical reading of the WHO study, he wrote, “suggests to me that again there is not very much to write home about.”
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For many doctors who treat African women, though, there’s little question about the negative effects of female circumcision—especially Type III, infibulation. “It is painful and destructive,” said Nawal Nour, a Boston gynecologist and one of the United States’ leading medical experts on female circumcision. A graduate of Harvard Medical School, Nour is the founder of the African Women’s Health Practice, the country’s first gynecological clinic devoted to African immigrants. She treats hundreds of infibulated women, mostly from Sudan and Somalia, although she has patients from other parts of the continent as well.

Like some defenders of the practice, she avoids the term “female genital mutilation” because, she said, “most of the women I treat don’t consider themselves mutilated.” Many consider infibulation beautiful. When they first realize American women are almost all uncircumcised, they tend to react with pity and disgust, not envy.

“Part of what I do here in the United States is to bring down that sensationalistic perspective—oh my god, these are barbaric individuals, how horrific, how can parents do this to their daughters,” said Nour. “When you truly understand the issues of female circumcision, it’s a tradition, it’s a rite of passage, it’s something that is celebrated in a lot of these places.” She understands why people like Shweder oppose blanket condemnation. “But they go a step too far, because I see the women who do have long-term complications. These long-term complications can go from minor, chronic vaginal infections to inability to penetrate, to have intercourse, to infertility, to very painful intercourse, to inability to deliver a baby,” she said. “You can’t tell me that they don’t have chronic issues.”

N
o one knows exactly when, why, or how infibulation began, but in Africa the practice has been tied up with globalization for hundreds of years. The political scientist Gerry Mackie has speculated that it derives from an area in what is now northern Sudan, and that it spread into other parts of Africa via the slave trade, becoming less severe as it diffused. (Interestingly, infibulation is often referred to as “pharonic” circumcision in countries that practice it, but it’s called “Sudanese” circumcision in Egypt.) “The geographic distribution of FGM suggests that it originated on the western coast of the Red Sea, where infibulation is most intense, diminishing to clitoridectomy in westward and southward radiation,” he wrote in an influential 1996 article. “Whatever the earliest origins of FGM, there is certainly an association between infibulation and slavery.”
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According to Mackie’s hypothesis, the demand for concubines among imperial Muslim rulers

induced an eastward flow of female slaves through the mainly polygynous Sudanic Belt into infibulating slave centers in Sudan and a westward flow of Islamization and FGM. Arabized pastoralists raided northeastern Africa for slaves and, because Islam forbade the enslavement of Moslems, ventured further as closer sources converted. The Sudanic slaves were shipped down Nile Valley routes or through the Red Sea to Egyptian or Arabian markets.... The further radiation of clitoridectomy follows the channel of raiding and trading west to the Atlantic and southeast to Kenya.
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Mackie cited Joao Dos Santos, a seventeenth-century missionary, who wrote of a group in Somalia who had “a custome to sew up their Females, specially their slaves being young to make them unable for conception, which makes these Slaves sell dearer, both for their chastitie, and for better confidence which their Masters put in them.”
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Even in the twentieth century the practice spread in the Sudan as Arabs from the country’s north moved into indigenous areas in the south and west. “As unschooled Islamic people who erroneously believe female circumcision to be part of their religion spread into these indigenous areas, they bring with them their customs which are eventually adopted by the less socially and economically advantaged indigenous population in order to make their daughters more marriageable,” wrote Hanny Lightfoot-Klein in her 1989 book,
Prisoners of Ritual: An Odyssey into Female Genital Circumcision in Africa,
which was pathbreaking for its comprehensive, on-the-ground research. She continued, “The spread of the practice is so complete that I found that in the city of Nyala in the west of Sudan, where the pharonic was completely unknown 50 years ago, it now saturates the area completely. The same is true of the somewhat more remote town of Nyertete where it was first introduced 20 years ago and where all of the population now practice it.”
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The relationship between female circumcision and Islam is complex, if undeniable. The practice predates Islam, and isn’t sanctioned by many orthodox interpretations of the religion; it is mentioned nowhere in the Koran and is virtually unknown in Saudi Arabia, for example, where it is widely considered barbaric. Nor is it practiced exclusively by Muslims in Africa—indeed, in Tanzania the highest circumcision rates are in predominantly Christian areas.
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Nevertheless, in large parts of Africa, Islam and female circumcision—especially infibulation—have been deeply intertwined. Closely tied to the conservative Muslim obsession with female virginity and chastity, it’s meant to attenuate women’s sexual desire and provide a physical barrier against premarital sex.
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A host of related beliefs surround female circumcision in the communities that perform it. “The belief that uncircumcised women cannot help but exhibit an unbridled and voracious appetite for promiscuous sex is prevalent in all societies that practice female circumcision,” wrote Lightfoot-Klein.
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In addition, some cultures believe that left alone a woman’s clitoris will grow to grotesque, penislike proportions, or that it is poisonous and will kill a man who comes into contact with it, or that it impedes fertility.
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Nawal Nour recalled, “I had a woman who said to me, ‘I really feel it’s important that my granddaughter be circumcised, because at this stage if I hadn’t had my clitoris removed it would be touching the ground!’ ”

C
hristian missionaries who encountered female circumcision were generally appalled and tried their best to stop it, though some, finding that their opposition hindered their attempts at conversion, condoned and even embraced it. When sixteenth-century missionaries in Ethiopia attempted to put an end to the practice, men refused to marry uncircumcised girls. “Circumcision was eventually allowed again on the urgent advice of Rome, so that the ground gained by the missionaries would not be lost as the converts failed to marry and reproduce,” wrote Lightfoot-Klein.
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British colonialists took a similar tack. They tended to see female genital cutting as a hideous, heathen custom to be eradicated by their civilizing mission, but they could also promote it in the service of other priorities. “As early as 1906, Church of Scotland (Presbyterian) missionaries at Kikuyu preached against excision together with its attendant celebrations, dances, and teachings as ‘barbaric’ and ‘indecent,’ ” wrote historian Lynn M. Thomas in her book
Politics of the Womb: Women, Reproduction, and the State in Kenya
. “Missionaries soon realized that female initiation posed a direct challenge to their education efforts, as girl students routinely left mission schools when their time for initiation approached. In an effort to stem the losses, missionaries experimented with holding female initiations on mission grounds.... [They] were carried out by the ‘usual Kikuyu woman circumciser.’ ”
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Throughout the ensuing decades the British made various attempts to ban female circumcision in Kenya, often eliciting furious opposition. In the late 1920s, Thomas wrote, thousands of young people gathered at schools or mission stations to perform
Muthirigu,
a form of dance-song mocking anticircumcision campaigns. “Elder of the Church, your uncircumcised daughter is pregnant and she will give birth to dogs,” was one lyric.
Muthirigu
was banned as seditious in 1930, but by then, wrote Thomas, “young men and women had already made their point. The vigor and scale of their performances had demonstrated to colonial officials the depth of local commitment to female excision.”
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Interestingly, in one region of Kenya the colonial government actually
enforced
circumcision, and at an earlier age, because officials felt it prevented an even greater ill: abortion. The Central Kenyan Meru people condoned sexual play among uninitiated, unmarried adolescents but considered children born to uncircumcised girls to be cursed, a view shared by some neighboring groups, including the Masai. Among the Meru, Thomas wrote, such pregnancies were dealt with by abortions, which were performed by men called
muriti wa mauu
, or “remover of the womb.”
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The colonial district commissioner considered rampant abortion “the principal social problem of the Meru people” and helped institute a policy of forced mass circumcisions in order to combat it. “He argued that apart from saving the Meru from ‘tribal death,’ it would reduce the age of marriage, compel men to shoulder the responsibilities of wife and family at a younger age, encourage them to farm, and, by shifting agricultural control from women to men, facilitate the development of cash crops.”
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Meru was an exception; in most of Kenya colonial opposition to female circumcision was fairly consistent and had the effect of imbuing the practice with anticolonial authenticity. In his 1938 book,
Facing Mount Kenya
, Jomo Kenyatta, the founding father of independent Kenya, described female circumcision as “the very essence of an institution which has enormous educational, social, moral, and religious implications, quite apart from the operation itself.... [L] ikeJewish circumcision, [it] ... is regarded as the conditio sine qua non of the whole teaching of tribal law, religion, and morality.”
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In the 1950s, defiance of the British ban on circumcision was associated with support for the anticolonial Mau Mau rebellion.

This legacy is often used to tar efforts to eradicate the practice as a kind of neocolonialism or secular missionary work. “[T]hese days at least two things have changed since the 1920s and 1930s in Africa: anesthesia is more available, and the ‘civilizing’ missionary efforts of militant Protestants have been supplemented and even supported by the evangelical interventions of global feminists and human rights activists,” wrote Shweder.
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Yet many African feminists bristle at the idea that opposition to excision and infibulation has been imposed on them by Westerners. Circumcision, insisted Grace Mose, is meant to instill humility and submission in women, and to prepare them for a life of pain. In the modern world, she insisted, women should have options besides stoic forbearance. “Why don’t we learn ways in which we can overcome hardships instead of enduring them?” she asked during her debate with Ahmadu. “We are not opposing it because we are following what the West is telling us. It’s because of our own personal experience. There is no Western woman who came to tell me, ‘This practice is painful.’ No. That is an experience that I went through, and I understood how painful it was.... No woman should have to deal with that.”