Today is International Day of Zero Tolerance for Female Genital Mutilation. GATE adds our voice to calls to end all forms of Female Genital Mutilation wherever practiced, and calls for recognition of the right of all children to bodily integrity.
Female Genital Mutilation refers to all procedures involving partial or total removal of the external female genitalia or other injury to the female genital organs for “non-medical reasons”.[1] It continues in many parts of the world, due to gender inequality, traditional and normative gender roles, including perceptions that the ritual facilitates women’s fuller participation in society, and that the procedure prepares women for adulthood.
UN institutions recognise that, in some cases, parents may be motivated to consent to female genital motivation because they see other parents doing so, while women subjected to the procedure may also exert pressures that promote conformity and ostracize others.[2] The World Health Organization and other bodies recognize that medicalization, including as a form of harm reduction, does not justify female genital mutilation.[1]
Yet perceptions of female genital mutilation are racialized, perceived as a problem of the global South. This racialization of female genital mutilation obscures medicalized practices in the global North, exposing a double standard.[3]
Not only are cosmetic labioplasties in Western countries frequently deemed acceptable in adults despite a criminalization of female genital mutilation,[4] the medicalization of girls with intersex variations excludes them from policy frameworks prohibiting female genital mutilation in countries including Australia,[5] Canada,[*,12] New Zealand,[6] the United Kingdom,[7] and the United States.[8]
In a case that exemplifies this moral hypocrisy, “Carla”, a young child with the intersex trait of 17-beta hydroxysteroid dehydrogenase 3, was subjected to a clitorectomy and labioplasty without oversight when she was aged three, and this was later described by a judge in a Family Court of Australia case in 2016 as surgery that “enhanced the appearance of her female genitalia”.[9]
Despite the World Health Organization position on female genital mutilation, early “feminizing” surgeries remain required in many cases like Carla’s, in the proposed International Classification of Diseases 11 beta:
“If the diagnosis is made at birth, gender assignment must be discussed, depending on the expected results of masculinizing genitoplasty. If female assignment is selected, feminizing genitoplasty and gonadectomy must be performed”[10]
Claims made in support of such surgeries typically appeal to the best interests of the child, based on normative gender stereotypes with the aim of facilitating full participation in society. In the case of “Carla”, for example the judgment discloses a set of normative gender stereotypes as rationales for the child’s sterilization, including her “Minnie Mouse underwear” and hair worn in long, blond braids.[9] The judge remarked that the child might require further surgery in future to make her body capable of heterosexual intercourse.[9]
The Yogyakarta Principles plus 10 calls for recognition of the right to bodily integrity for all people, irrespective of their sex characteristics, stating:
“No one shall be subjected to invasive or irreversible medical procedures that modify sex characteristics without their free, prior and informed consent, unless necessary to avoid serious, urgent and irreparable harm to the concerned person”.[11]
All states must act to end all forced and coercive genital mutilations. They must “act to guarantee and protect the rights of everyone, including all children, to bodily and mental integrity, autonomy and self-determination”.[11] States must “ensure that the concept of the best interest of the child is not manipulated to justify practices that conflict with the child’s right to bodily integrity”.[11]
In solidarity,
The GATE Team
February 6th, 2018.
Read the GATE Submission to WHO on Intersex Issues in the process of ICD reform
[1] World Health Organization, Office of the High Commissioner for Human Rights, UNAIDS, UNDP, UNECA, UNESCO, et al. Eliminating female genital mutilation: an interagency statement. Geneva: World Health Organization; 2008.
[2] Committee on the Elimination of Discrimination against Women, General Comment 31, and Committee on the Rights of the Child, General Comment 18 (CEDAW/C/GC/31-CRC/C/GC/18), 2014, para 57
[3] Ehrenreich N, Barr M. Intersex Surgery, Female Genital Cutting, and the Selective Condemnation of ‘Cultural Practices’. Harvard Civil Rights-Civil Liberties Law Review. 2005 Winter;40(1):71–140; Jones M. Intersex Genital Mutilation – A Western Version of FGM. The International Journal of Children’s Rights. 2017;25(2):396–411.
[4] Spriggs M. Parent-led request for female genital cosmetic surgery in an adolescent. In: When Doctors and Parents Disagree: Ethics, Paediatrics and the Zone of Parental Discretion. Annandale, NSW, Australia: Federation Press; 2016. p. 227–43.
[5] Carpenter M, Organisation Intersex International Australia. Shadow Report submission to the Human Rights Committee on the situation of intersex people in Australia [Internet]. 2017 Aug [cited 2017 Aug 29]. Available from: https://oii.org.au/31568/shadow-report-iccpr-2017/
[6] Asia Pacific Forum of National Human Rights Institutions. Promoting and Protecting Human Rights in relation to Sexual Orientation, Gender Identity and Sex Characteristics [Internet]. Sydney, Australia: Asia Pacific Forum of National Human Rights Institutions; 2016 [cited 2016 Jun 16]. Available from: http://www.asiapacificforum.net/resources/manual-sogi-and-sex-charactersitics/, pages 74 to 75
[7] Shahvisi A, Earp BD. The Law and Ethics of Female Genital Cutting. In: Creighton S, Liao L-M, editors. Female Genital Cosmetic Surgery: Interdisciplinary Analysis & Solution. Cambridge, England: Cambridge University Press; 2018.
[8] Human Rights Watch. “I Want to Be Like Nature Made Me” [Internet]. 2017 [cited 2017 Jul 25]. Available from: https://www.hrw.org/report/2017/07/25/i-want-be-nature-made-me/medically-unnecessary-surgeries-intersex-children-us, pages 149 to 152
[9] Re: Carla (Medical procedure) [2016] FamCA 7 (20 January 2016); Carpenter M. The ‘normalisation’ of intersex bodies and ‘othering’ of intersex identities, the experience in Australia. In: Scherpe J, Dutta A, Helms T, editors. The Legal Status of Intersex Persons. Cambridge, England: Intersentia; forthcoming (April 2018).
[10] World Health Organization. 46,XY disorder of sex development due to 17-beta-hydroxysteroid dehydrogenase 3 deficiency. In: ICD-11 Beta Draft (Foundation) [Internet]. 2018 [cited 2018 Jan 12]. Available from: https://icd.who.int/dev11/f/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f887793448
[11] Yogyakarta Principles. The Yogyakarta Principles Plus 10: Additional Principles and State Obligations on the Application of International Human Rights Law in Relation to Sexual Orientation, Gender Identity, Gender Expression and Sex Characteristics, to Complement the Yogyakarta Principles. 2017.
[12] Criminal Code (R.S.C., 1985, c. C-46). Available from: http://laws-lois.justice.gc.ca/eng/acts/C-46/page-63.html#docCont
[*] Country added on 9 February.