“We want everyone to look at FGM not as a standalone issue, but as violence against women and children that cannot be solved unless it’s addressed with other issues,” such as child marriage, said Dukureh, the founder of Safe Hands for Girls, which has offices in The Gambia and in Atlanta.

Global goals adopted by the United Nations in 2015 set a target of 2030 for ending the practice, which involves removing healthy and normal female genital tissue, especially the clitoris. The conference at USIP brought together a spectrum of government officials, medical and other professionals, religious and community leaders, and activists. It was co-sponsored by Dukureh’s group as well as the international human rights organization Equality Now and the newly formed U.S. Network to End FGM/C, with support from the Wallace Global Fund and the Human Dignity Foundation.

“FGM/C is no different than any other form of oppression against women and girls. When we end that oppression, we’ll end violence against women and girls.” -- Leyla Hussein, survivor and founder of The Dahlia Project

The topic has received renewed attention recently. Just last week, Egypt issued stricter penalties for those performing the procedures. Police forces in Kenya and Tanzania are partnering to prevent citizens from crossing the border for illegal procedures. And in Lagos, Nigeria, the governor’s wife, who founded the organization Hope For Women in Nigeria Initiative, has called for renewing and updating laws banning the practice.

Such harmful practices tend to flourish in places that are fragile or embroiled in violent conflict, where laws are either non-existent or cannot be enforced to protect the rights of girls, according to USIP Senior Gender Advisor Kathleen Kuehnast.

“In emergency situations, girls and women are especially vulnerable to harmful traditional practices, as with the case of female gen­ital mutilation, which often goes hand in hand with forced early marriage,” she and co-author Nora Dudwick wrote in a policy brief for the Fragility Study Group, a project of the Carnegie Endowment for International Peace, the Center for a New American Security and USIP. “Because of this ambivalence about interfering with `cultural traditions,’ U.S. policy has not been strong enough in fighting antiquated, dangerous and criminal practices that are especially aimed at girl children,” they wrote.

Eliminating the practice of female genital mutilation, also known as female genital cutting or FGM/C, will require a multi-pronged approach involving education, health, legal and religious institutions, panelists said at the conference. The evocative nature of the subject is reflected in the compound term for it, which represents a compromise among advocates of eliminating the practice.

First U.S. Legislation

"If this isn't an issue of human rights, there isn't an issue in the world that is human rights,” U.S. Senate Minority Leader Harry Reid, who two decades ago successfully sponsored the first U.S. legislation against female genital mutilation, said at the event. “If a report came out that 200 million boys had had a testicle removed, would the world stay silent?”

Jaha Dukureh, Safe Hands for Girls

Female genital mutilation/cutting involves surgically removing a portion of a young girl’s genitalia, namely the clitoris, with sharp instruments such as a razor blade, scissors or even broken glass. Ostensibly, the practice is intended as a rite of passage into womanhood, or to keep her “pure” by in some cases making it physically impossible to have sex.

While it would be easy to think of FGM/C as a problem that only occurs in other parts of the world, it also affects women and girls in the United States. A report issued in November 2016 found an estimated 513,000 women and girls in the United States have experienced or are at risk of FGM/C. Women who perform the procedure sometimes are brought from abroad to perform FGM/C in the U.S. In other cases, families take their girls to their ancestral countries ostensibly on “vacation,” and a girl may have no idea what’s coming until she is forced to undergo the cutting. However, attempts to curtail or eliminate the dangerous practice in the United States have been scattershot.

According to the doctors and other health experts at the conference, FGM/C carries significant health risks and consequences, including the possibility of hemorrhaging, intense pain and, later, extremely painful intercourse, difficulty in conceiving and in childbirth, and even death. Although those who oppose the custom consider it to be violence against women, it is mostly women—midwives, mothers, aunts—who perform it on the female infants and young girls of their communities.

Ending female genital mutilation/cutting is enshrined in the U.N. Sustainable Development Goals adopted in 2015. In a section on “achieving gender equality and empowering girls,” Goal 5.3 calls on the world to “Eliminate all harmful practices, such as child, early and forced marriage and female genital mutilation” by 2030.

Lifelong Effects

“We know that, although there has been a lot of progress in legal, community, education and health approaches, too many girls continue to live with the very profound impact of this practice, and they have lifelong physical and psychological impacts,” USIP President Nancy Lindborg told the conference audience. “Too many lose their lives.”

To tackle the practice, one approach should be to change the language used to discuss it, said psychotherapist and survivor Leyla Hussein.

“There was a lack of understanding about what FGM was for many, many years,” said Hussein, who is founder of the London-based Dahlia Project, which counsels survivors of female genital cutting. “I’ve walked into arenas where it was called culture or religion. Clearly, for me, this is one of the worst forms of child abuse.”

“FGM is no different than any other form of oppression against women and girls,” Hussein said. “When we end that oppression, we’ll end violence against women and girls.” 

Complicating the issues of race and gender are traditions that can vary greatly by country, as well as the age of the young girls when they are cut. Some girls are so young they have no memories of being cut, and can suffer from confusion about their anatomy as they mature. Others who are older experience trauma, post-traumatic disorder, feelings of shame, distorted body images, and a sense of betrayal by those involved in what often is a surprise assault.

Manal Taha, a former Jennings Randolph Senior Fellow at USIP who attended the event, said that part of the difficulty in ending the practice is that each country has its own reasons for practicing it.

“There is no one solution,” said Taha, who is from Sudan, where FGM/C is a common practice. “We need all of them. We need law enforcement and the religious leaders and the policymakers and the activists—all of them, working together, to end this practice,” she said.

Law Enforcement, Immigration, Education

And multiple solutions can be woven together to tackle the singular problem. Experts at the conference said engaging law enforcement professionals to understand female genital mutilation/cutting, identify existing laws and create new ones where appropriate, can be combined with outreach and education to community groups and health professionals to curtail the practice, recognize signs of a girl who has been cut, and intervene in the most effective way.

“We’re not going to legislate our way out of this, but it is one tool in the toolbox,” said Jeanne Smoot, senior counsel for policy and strategy at the U.S.-based Tahirih Justice Center, which helps immigrant women and children fleeing violence. “FGM/C needs to be recognized and classified as child abuse at the local, state and federal levels.” That way, people who are in a position to help are more likely to be aware of the laws and trained on how to apply the range of protections that exist, as is the case with more well-known types of child abuse, Smoot said.

Other existing services also can be better utilized, said Nina Smart, founder of SWF International, a nonprofit organization that seeks to end female genital mutilation/cutting in Sierra Leone and among immigrant communities in the U.S. through public education. U.S. Citizenship and Immigration Services, for instance, provides several resources on their website for understanding and preventing FGM/C, but could better promote those resources, she said. One way would be to ensure that the information reaches not only the male head of a household coming through immigration but also the accompanying women and children who can read, Smart said.

“The U.S. Department of Education should develop and disseminate FGM/C educational and training materials to schools, universities, the diaspora community groups, healthcare professionals, police and others upon request,” said Angela Peabody, the executive director and founder of Global Woman PEACE Foundation, based in Virginia.

Representative Joseph Crowley from New York vowed his commitment to ending this form of brutality against girls. He expressed confidence that, despite the wide use of the practice and its myriad causes and consequences, if tackled from all sides and using every possible resource, female genital mutilation/cutting could be eradicated within a generation.