The practice of female genital manipulation (FGM), is practiced in 30 countries worldwide. In Africa and parts of Asia, it is believed that 2 million women are circumcised each year; in other words, 6000 women every day. In the west and other cultures unfamiliar with the practice, the custom is seen as outrageous and barbaric. But FGM is neither a modern phenomenon nor one restricted to Africa and Asia. According to modern sociology, the practice is just a 'natural continuation of the ancient patriarchal repression of female sexuality'. The Romans kept tabs on their slave girls by inserting genital rings. The Crusaders in the 12th century introduced the chastity belt to Europe in order to keep their wives under lock and key, while they campaigned abroad.

In 19th century Europe and America, doctors counseled operations on female genitalia to treat a variety of anti-social conditions, including nymphomania (Hey, why isn't there isn't a word for over-sexed males?), insanity, hysteria, and depression. A London practitioner by the name of Dr. Isaac Baker Brown advocated genital manipulation with a pair of scissors in order to treat 'insomnia' and 'unhappy marriages'. In New York in the 1950s, a young girl underwent a clitoridectomy (the removal of the clitoris) because her family suspected her of masturbating. Prostitutes were encouraged to undergo similar operations by church evangelists to rehabilitate them. In no other continent though, does it have such a strong hold as Africa. The type and severity of the mutilation depends on the particular traditions of the different groups.

There are three types of manipulation. 'Circumcision' involves the removal of the prepuce of hood of the clitoris; it is the least severe, but also the least practiced. 'Excision' involves the removal of all or some of the clitoris and all or part of the inner genitalia. it is the commonest form of mutilation, and accounts for 80% of the cases. 'Infibulation' is the severest form and requires the removal of the clitoris, the inner genitals and most or all of the outer genitals (labia major). The 2 sides of the vulva are then stitched together with catgut, thread, reed or thorns. A tiny opening is preserved by the insertion of a twig, allowing for the passing of urine. The girl's legs are then bound for 40 days to allow the formation of scar tissue.

Operations are carried out with a variety of instruments including knives, glass, scissors, pieces of glass, or as they become more available, razor blades. Sometimes sharp stones have been used, or in Ethiopia, cauterization (burning). Usually girls between the ages of 4 and 14 undergo the operation, though sometimes it is performed after a woman delivers her first child. The operation is usually the responsibility of one woman in the group. Except for very rich families in the hospitals of big cities, no anaesthesia is ever employed. The area of the Horn, encompassing Ethiopia, Eritrea, Djibouti and Somalia is home to a particular rampant tradition of female circumcision. In Djiobouti, 95% of women are estimated to Infibulated (the severest form).

Westerners are quick to express outrage, however, these traditions are deeply entrenched and are inextricably tied up in the religious, cultural, and social lives of the inhabitants. One reason given for the practice is hygiene. In hot climates where water for washing is not readily available, the removal of the genitals is thought to promote cleanliness. Aesthetics is another consideration. Genitals are considered ugly and dirty: a flat smooth area of skin is considered pleasing to the sight and touch.

Superstition plays a part as well. In Ethiopia, some groups believe if the female genitalia isn't removed, they will continue to grow as a man's do, into puberty. Some believe the uncircumcised woman can't conceive; others believe that if she does, the unexcised clitoris will kill the first born child just by coming into contact with it.

The sense of belonging and identification plays an extremely important part in most African's lives (and the issue least understood by non-Africans). Just as male circumcision is seen as crucial to Jewish tradition, so is female circumcision seen to some African traditions.

Another common defense for FGM is the claim that it prevents female promiscuity. After genital manipulation, the female is said to have her libido lessened for life. In some Muslim countries, where polygamy is permitted, circumcision is said to lessen the demands that wives put on a single husband.

Circumcision is also a means to guaranty the virginity of a future bride. In some countries it is a young girl's duty to attend to the herds, obliging her to spend long hours alone. Circumcision is designed to 'protect' her and discourage the roving eye os nomadic men (if a girl was raped, it would be obvious and a perpetrator would be found) virginity in all traditional African societies is a prerequisite for marriage. It reflects the prestige of the girl's family and assures a good 'market-value' for the bride.

There is no doubt female genital mutilation brings enormous physical and psychological pain and suffering. Postoperative complications involve hemorrhage, damage to other organs or bones from badly performed operations or struggling patients, and septicemia as a result of using unsterilized instruments. Doctors estimate that 15% os all girls die post-operatively of infections or bleeding.

Those who survive often suffer ongoing complications such as infections or abbesses, or even, after infibulation, an inability to empty the bladder fully because of the narrowness of the opening after the operation. The next chapter in a girl's life, the marriage night and childbirth, bring repeat experiences of unbearable pain and sometimes life-threatening danger.

Though little studied to date, the psychological damage of the operation is considered no less serious. Cases of severe depression, frigidity, anxiety and very low self-worth have often been reported. As one doctor put it, "These girls are holding back a scream so strong, it would shake the earth".

Most of the arguments for FGM as outlined above are based in superstitions, myth or perpetual tradition. However, if elimination of the practice is to be brought about, it will not be through the edicts of government proclaiming, "this is illegal", nor the lectures claiming, "this is barbaric". A grassroots campaign is required to that seeks to understand as well as confront the deeply ingrained traditions of the local people. Above all it will depend on the courage of the victims themselves. As Capt. Thomas Sankara, the late pres. of Burkino Faso, put it:

...the liberation of women in our country, the women of Africa, of women as a whole, will not come about as an act of charity. It will depend on their will and their determination to struggle..."