Female genital mutilation (FGM), or the ritual excision of part or all of the external female genitalia, is an ancient cultural practice that occurs around the world today, especially in
Africa. With recent immigration to Canada of peoples from Somalia, Ethiopia and Eritrea, Sudan and Nigeria, women who have undergone this practice are now increasingly living in Canada.
It is firmly believed by the people who practise it, that FGM improves feminine hygiene, that it will help eliminate disease and it is thought to be the only way to preserve family honour, a girl's virginity and her marriageability. FGM has a number of important adverse health effects including risks of infection and excessive bleeding (often performed when a girl is pre-pubertal). Subsequently there can be chronic problems with urination, menstruation, sexual relations, birth control, infertility, as well as difficulties with pregnancy and childbirth. Although many women adapt to this practice, others are traumatized by it. Because of its profound effect on health, a number of medical organizations have developed policy statements condemning this practice.
In Canada, as well as in most Western countries, FGM is illegal. People conducting this practice can be charged with aggravated assault and those who participate in the commission of FGM can also be charged. There is legal precedent in Canada for women to seek refugee
status who are under pressure to undergo FGM against their will. FGM is considered to be a form of child abuse, and children who are at imminent risk may be removed from their family
home to prevent its occurrence.
The Federal Interdepartmental Working Group on FGM commissioned key informant* research across Canada in the late 1990s, to examine the health care issues of affected women and to identify some prevention strategies. With respect to health care issues, community
providers and health care providers identified the following:
- Affected women may not realize their symptoms are FGM-related or preventable.
- Affected women tend to seek health care only when it is urgent.
- Even when affected women do want health care, they are reluctant to seek it due to a
number of social factors.
- When affected women do seek health care they may find it difficult and traumatic due to
cultural and language barriers.
- Health care providers may not be sensitized to certain critical FGM related issues.
- The high Cesarean section rate is the number one health care concern of affected women.
- Key informants were concerned that FGM may be happening in Canada.
- Health care providers rarely have the opportunity to identify girls at risk.
- Schools could play an important role in identifying girls at risk.
A number of recommendations from the key informants arose from these findings.
In September 1999, representatives from a number of national organizations interested in the issue of female genital mutilation (FGM), met with members of the Federal Interdepartmental Working Group for a National Consultation. The results of the key informant research was
discussed and further recommendations were made. Recommendations from both the key informants and the National Consultation can be found in Section 6 of this document.
*NOTE* "Key informant" refers to those individuals who took part in the interviews and research conducted for this report.
Patricia Huston MD, MPH
Scientific Communications International, Inc
for the Federal Interdepartmental Working Group on FGM