The New England Journal of Medicine Nahid Toubia
N Engl J Med 1994; 331:712-716 September 15, 1994
In many civilizations, certain surgical procedures have profound cultural and social meanings. Male circumcision, for example, has deep importance as a symbol of religious and ethnic identity and has played a major part in the political and social history of many peoples1. Female circumcision has particularly strong cultural meaning because it is closely linked to women's sexuality and their reproductive role in society.
Female circumcision is practiced today in 26 African countries, with prevalence rates ranging from 5 percent to 99 percent. It is rarely practiced in Asia. It is estimated that at least 100 million women are circumcised. The practice is known across socioeconomic classes and among different ethnic and cultural groups, including Christians, Muslims, Jews, and followers of indigenous African religions2. From the perspective of public health, female circumcision is much more damaging than male circumcision. The mildest form, clitoridectomy, is anatomically equivalent to amputation of the penis. Under the conditions in which most procedures take place, female circumcision constitutes a health hazard with short- and long-term physical complications and psychological effects. The influx of refugees and immigrants from different parts of Africa to North America, Europe, and Australia in the past decade requires that physicians and other health professionals familiarize themselves with the practice and its ramifications for their patients.
This article reviews the common types of circumcision, their complications, and the challenges in giving appropriate care to circumcised women. In counseling families who believe in the practice, it is important to understand the depth of cultural meaning it carries. Finally, a brief review of legal and ethical issues will include consideration of existing and expected pieces of legislation and what they mean to the medical profession.
For Further Reading
Female Circumcision as a Public Health Issue
http://www.nejm.org/doi/full/10.1056/nejm199409153311106
N Engl J Med 1994; 331:712-716 September 15, 1994
In many civilizations, certain surgical procedures have profound cultural and social meanings. Male circumcision, for example, has deep importance as a symbol of religious and ethnic identity and has played a major part in the political and social history of many peoples1. Female circumcision has particularly strong cultural meaning because it is closely linked to women's sexuality and their reproductive role in society.
Female circumcision is practiced today in 26 African countries, with prevalence rates ranging from 5 percent to 99 percent. It is rarely practiced in Asia. It is estimated that at least 100 million women are circumcised. The practice is known across socioeconomic classes and among different ethnic and cultural groups, including Christians, Muslims, Jews, and followers of indigenous African religions2. From the perspective of public health, female circumcision is much more damaging than male circumcision. The mildest form, clitoridectomy, is anatomically equivalent to amputation of the penis. Under the conditions in which most procedures take place, female circumcision constitutes a health hazard with short- and long-term physical complications and psychological effects. The influx of refugees and immigrants from different parts of Africa to North America, Europe, and Australia in the past decade requires that physicians and other health professionals familiarize themselves with the practice and its ramifications for their patients.
This article reviews the common types of circumcision, their complications, and the challenges in giving appropriate care to circumcised women. In counseling families who believe in the practice, it is important to understand the depth of cultural meaning it carries. Finally, a brief review of legal and ethical issues will include consideration of existing and expected pieces of legislation and what they mean to the medical profession.
For Further Reading
Female Circumcision as a Public Health Issue
http://www.nejm.org/doi/full/10.1056/nejm199409153311106
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