This discussion within this Community of Practice will deep-dive into the issue of type IV FGM and other types of female genital alterations.
The World Health Organization classifies FGM into 4 main types and considers all types of FGM to be a violation of the human rights of girls and women. FGM type IV encompasses a range of procedures carried out on the female genitals that do not fall under the first 3 types (partial or total removal of the clitoral gland, excision of the labia minora or majora, and infibulation).
The definition for type IV was adapted in the new typology, published in 2007, to be less detailed than the previous one (1995). Practices such as the introduction of corrosive substances and herbs into the vagina, as well as labia stretching were removed but are still practiced by numerous communities.
As usual, we have prepared a Thematic note for the members. This note gives information on the main types of FGM IV.
- Genital piercing
- Vaginal incisions, scraping, hymenotomy, including
- Dangouria/Haabize, Angurya and Gishiri in Niger and Nigeria
- “removal of warts” (southieutes) in Senegal
- Incisions to introduce herbs, South Africa
As well as other types of female genital alterations which are not currently included in the WHO typology:
- Labia elongation, stretching or pullin
- Vaginal drying
- Esthetical genital surgeries
- Clitoris massaging
What are they? Where & Why are they practiced? Why are some of them not considered as “FGM”? What are the consequences of these practices on the lives of the women/girls who undergo them?
What are the controversies around some of these practices?
This list is not exhaustive, nor is the information given on each type (such as country/community practicing).
Africa, 2016, Type 4 FGM – Focus: Labia elongation, Access here
Agence Nationale de la Statistique et de la Démographie (ANSD) Sénégal & ICF, 2018, Sénégal : Enquête Démographique et de Santé Continue 2017, Access here
Anonymous author, 2016, Female genital mutilation – An agonising choice, Access here
Arora K. S. & Jacobs A. J., 2018, Female genital alterations: A compromise solution, Access here
Askew I. et al, 2016, A repeat call for complete abandonment of FGM, Access here
Audet, C.,M. et al, 2017, Understanding intra-vaginal and labia minora elongation practices among women heads-of-households in Zambézia Province, Mozambique, Access here
Bagnol B. & Mariano E., 2008, Vaginal practices: eroticism and implications for women’s health and condom use in Mozambique, Access here
Caliendo, C. et al, 2005, Self-reported characteristics of women and men with intimate body piercings, Access here
Community of Practice on FGM, 2019, “The Removal of the Southieuntes” in Senegal : An unknown type of FGM IV – Interview with Fatou, Access here
Ghanaweb, 2016, Genital piercing increasing among Kumasi youth, Ghanaweb, Access here
Kelly B. & Foster C., 2012, Should female genital cosmetic surgery and genital piercing be regarded ethically and legally as female genital mutilation?, Access here
Kitui, B. 2012, Female genital mutilation in South Africa, Access here
Koster M. & Price L, 2008, Rwandan female genital modification: Elongation of the Labia minora and the use of local botanical species, Culture, Health & Sexuality, Access here
Lunde, I. & Sagbakken, M., 2014, Female genital cutting in Hargeisa, Somaliland: is there a move towards less severe forms?, Access here
Mandal, A., 2018, Health guide for young women regarding labiaplasty, Access here
Millner V., S. et al, 2005, First glimpse of the functional benefits of clitoral hood piercings, American Journal of Obstetrics and Gynecology, Access here
Moulton, L. J. and Jernigan, A. M., 2017, Management of Retained Genital Piercings: A Case Report and Review. Case Reports in Obstetrics and Gynecology, Access here
National Population Commission (NPC) [Nigeria] and ICF International, 2014, Nigeria Demographic and Health Survey 2013, Abuja, Nigeria, and Rockville, Maryland, USA: NPC and ICF International.
National Population Commission (NPC) [Nigeria] and ICF Macro, 2009, Nigeria Demographic and Health Survey 2008, Access here
Obianwu, O., 2019, personal communication
Ouedraogo, T., et al, 2018, Gurya cutting and female genital fistulas in Niger: ten cases, Access here
Perez, G. M. et al, 2015, Zambian Women in South Africa: Insights Into Health Experiences of Labia Elongation, Access here
Preslar D., Borger J., 2019, Body piercing infections, Access here
Richard F., 2018, Why we should be against the medicalisation of Female Genital Mutilation, International Health Policies, Access here
Scorgie, F. et al, 2010, “Cutting for love”: genital incisions to enhance sexual desirability and commitment in KwaZulu-Natal, SouthAfrica, Access here
Thomas, L., 2018, Labia Stretching, Access here
UNHCR, 2001, Guinea: Report on Female Genital Mutilation (FGM) or Female Genital Cutting (FGC), Access here
UNICEF, Unknown year of publication, Priorities in child survival, education and protection, Access here
Wahlberg A. et al, 2017, Factors associated with the support of pricking (female genital cutting type IV) among Somali immigrants, Reproductive Health, Access here
WHO, 2008, Eliminating Female genital mutilation: An interagency statement, Access here
WHO, 2018, Female genital mutilation, Access here
RESOURCES SHARED BY MEMBERS
Dridi Ibtissem B., 2010, Est-ce que ça marche? A propos du tasfih, rituel protecteur de la virginité des jeunes filles tunisiennes, Access here
FDA, 2018, Warns Against Use of Energy-Based Devices to Perform Vaginal ‘Rejuvenation’ or Vaginal Cosmetic Procedures: FDA Safety Communication, Access here
Federal Register, 2006, Skin bleaching drug products for over-the-counter Human use; Proposed rule, Access here
Ferhati B., 2010, Les clôtures symboliques des Algériennes : la virginité ou l’honneur social en question, Access here
Oranges C.M., Sisti A. & Sisti G, 2015, Techniques de réduction de la Labiaminora: une revue complète de la littérature, Access here
Ouar N., Guillier D., Moris V., Revol M., Francois C. & Cristofari S., 2017, Complications post-opératoires des nymphoplasties de réduction. Étude comparative rétrospective entre résections longitudinale et cunéiforme, Access here
Runacres S. A. & Wood P. L., 2016, Cosmetic labia plasty in an adolescent population, Access here
Shaw D., Lefebvre G., Bouchard, C., Shapiro, J., Blake, J., Allen, L & Awadalla, A., 2013, Chirurgie esthétique génitale chez la femme, Access here
Smarrito S., 2017, Classification of labia minora hypertrophy: A retrospective study of 100 patient cases, Access here
Yurteri-Kaplan L., Miranne J. M. & Iglesia C. B., 2014, Vulvaranatomyand labiaminoraplasty, Access here
“The Community of Practice on Female Genital Mutilation” is part of the “Building Bridges between Africa and Europe to tackle FGM” project, supported by the “UNFPA-UNICEF Joint Programme on the Elimination of FGM”.
The project is coordinated by AIDOS in partnership with GAMS Belgium.
The views expressed on this website are those of the authors and do not necessarily reflect the official policy or position of the UNFPA, UNICEF or any other agency or organization.
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