The Medicalisation of Sex

Female Genital Mutilation (FGM)

Defined by the World Health Organisation (2018), Female Genital Mutilation (FGM) is the procedure of “intentionally altering or causing injury to the female genital organs for non-medical reasons”. The history of FGM is not clearly documented, but the practice of FGM dates back 2000 years (Fgmnationalgroup.org, 2019). It is unclear where FGM originated, however, it was believed to have been practiced in Ancient Egypt as a symbol of distinction among the aristocracy (Fgmnationalgroup.org, 2019). UNICEF describes FGM as a “rooted tradition that is perceived, by many societies to be a religious obligation” (Momoh, 2005: 2). It has been recorded that more than 200 million girls and women, with an estimate of 3 million more are at risk of undergoing FGM every year (28toomany.org, 2019). Many women and girls have been subjected to FGM within 30 countries in Asia, Africa and the Middle East where FGM is concentrated (World Health Organisation, 2018). FGM is carried out mostly on girls between the ages of infancy to 15 years of age and is extensively recognised internationally as a violation of women and girls’ human rights (UNICEF, 2018).

In recent years there has been a growing trend regarding the medicalisation of FGM. Medicalised FGM has increased in a number of countries such as Egypt, Kenya and Yemen. The medicalisation of FGM in Egypt is currently a huge challenge, with 78.4% of FGM being carried out by medical health professionals (Wilson, 2016). There is a growing involvement of medical professionals in FGM with an increase in the provision of medical equipment being used for the procedure (Wilson, 2016).  Acts of FGM are usually paid for at high prices, in return for ‘better quality’ and safety (Chambers, 2009).

In society, harm-reduction is a paradigm within medicine that aims to minimize the effects and hazards associated with a risky behaviour or procedure such as FGM. Harm-reduction promotes alternatives which are seen as culturally acceptable and reduces the harm done to an individual (Shell-Duncan, 2001). The harm-reduction strategy within medicalisation is seen to potentially improve the health of women who undergo FGM (Shell-Duncan, 2001).

The harm-reduction strategy is one of the main reasons provided in support to the medicalisation of FGM. The defenders of the harm-reduction strategy argue that medicalised FGM decreases the risk of complications, which ensures that the procedure is carried out in a more sterile environment, with trained cutters, reducing pain by using anaesthetics (Shell-Duncan, 2001).

Although individuals have argued that the medicalisation of FGM reduces the risk of infections and dangers such as blood loss, it can be argued that they are contradicting the aim of eliminating FGM (Shell-Duncan, 2001). It is giving medical support to a procedure that is not only dangerous, but also morally and ethically wrong (Wilson, 2016). The medicalisation of FGM might help to minimise pain and infection but fails to recognise the psychological issues that cutting may trigger (Derby, 2004). Medicalisation in turn, is not a solution for FGM. The process of medicalisation is institutionalising and reinforcing the practices of FGM. Medicalisation is being used to legitimise FGM rather than trying to eradicate it (Wilson, 2016). 

This supports Illich’s notion of medical imperialism (1976) as modern medicine does more harm than good. It also links to the idea of clinical iatrogenesis. Illich (1976) refers to cultural iatrogenesis as the negative consequences of medical intervention. The consequences of medical intervention include the damage that is done to patients both physically and mentally from the surgery they undergo (Morrall, 2009). Women and girls are left to deal with the traumatic event and live with the prospect of life-threatening complications. 

Although FGM is seen as a cultural practice among many countries in Africa and the Middle East, the medicalisation of this procedure has been criticised by feminists, as the procedure is the root cause of oppression for both women and girls in terms of patriarchy and traditional beliefs (Mwanri and Gatwiri, 2017). The patriarchal societies that conduct FGM tend to marginalise women and girls. Additionally, FGM is usually carried out by older women as through traditional cultural norms, they believe the procedure of FGM will increase women’s attractiveness (Gatwiri and Fraser, 2015). Therefore, this reinforces the ideologies of patriarchy as the women who practise FGM are themselves a product of the patriarchal society who perform FGM to achieve cultural expectations (Mwanri and Gatwiri, 2017) as it ‘modifies’ and renders women’s bodies as a way of meeting patriarchal desires (Gatwiri and Mumbi, 2015).

Furthermore, Foucault’s view on the construction of ‘normality’ in terms of bodies interacts with the traditional and patriarchal norms of FGM as it produces “disciplined bodies that are easy to control” (Mwanri and Gatwiri, 2017: 4). The sexualisation of female bodies, for the benefit of men, begins at an early age, resulting in the limits of educational attainment and the underpinning of gender inequality (Coy, 2009).  Additionally, Foucault’s theory of biopower, relates to the practice in which nation states target the body through regulation and discipline to produce the ‘normal’ body (Harjunen, 2017). Within African and Middle Eastern countries, it is seen as the norm for female relatives to commit FGM on other women and girls, following the traditions of the patriarchal system, in which FGM creates the ‘ideal’ body for the desires of the patriarchy.

By Caitlin Martin