"I went to a doctor for the problem I have down there," Ramsey says. "He asked me, 'Why did they do this to you? Why did they remove all your genitalia?' He was in shock." After returning to her apartment, depressed and confused, Ramsey, a devout Christian, prayed for some answers. Later that night she saw a television program about FGM and the Nigerian woman's asylum case in Oregon. It answered many of her questions. "I was angry and still am. The morning after the show I got up and called all the African women from my address book who live in the United States. I asked them, 'Are you a victim too?' And they said yes. I said, `Let's talk about it. I'm not going to shut up anymore.'"
MOST of the talk about circumcision in this country has focused on male circumcision, as people have made the case that it causes physical and psychological pain to infant boys. When it comes to women, "circumcision" is at best a misnomer.
"Cutting off the clitoris is equivalent to cutting off much of the penis," Asha Mohamud says.
This is why opponents and medical leaders use the more descriptive and more accurate term "female genital mutilation." Although in a tiny percentage of cases FGM consists of a small cut to the hood of the clitoris, typically it is much more severe. It usually involves the complete removal of the clitoris, and often the removal of some of the inner and outer labia. In its most extreme form—infibulation—almost all the external genitalia are cut away, the remaining flesh from the outer labia is sewn together, or infibulated, and the girl's legs are bound from ankle to waist for several weeks while scar tissue closes up the vagina almost completely. A small hole, typically about the diameter of a pencil, is left for urination and menstruation. The cutting is usually done with a razor, a kitchen knife, or a pair of scissors. It is rare for any anesthesia to be used. The age at which FGMis performed varies among countries and communities. In some countries it is done on infants in the days or weeks after birth; in others, such as Senegal, it is part of an elaborate rite of passage that comes with puberty. In parts of Nigeria and Burkina Faso, FGM is practiced during the seventh month of a woman's first pregnancy, in the belief that if the baby at birth comes in contact with its mother's clitoris, it will die.
There is no doubt within the medical community that FGM is a brutal, harmful practice. A World Health Organization report on FGM says,
The immediate physical effects—acute infection, tetanus, bleeding of adjacent organs, shock resulting from violent pain, and hemorrhage—can even cause death. In fact, many such deaths have occurred and continue to occur as a result of this traditional practice. The lifelong physical and psychological debilities resulting from female genital mutilations are manifold: chronic pelvic infections, keloids, vulval abscesses, sterility, incontinence, depression, anxiety and even psychosis, sexual dysfunction and marital disharmony, and obstetric complications with risk to both the infant or fetus and the mother.
The American and British medical professions have in the past practiced FGM to varying degrees. There are reports of clitoridectomies having been performed as recently as the 1950s, to cure nymphomania and melancholia in girls. In the nineteenth century both clitoridectomies and female castration (removal of the ovaries) were practiced by British and American physicians, as cures for melancholia, masturbation, nymphomania, hysteria, lesbianism, and epilepsy. The American medical profession stopped performing clitoridectomies decades ago, only to find itself today confronting the practice in patients from cultures that perform FGM.