Female genital mutilation (FGM), also known as female circumcision or female genital cutting, includes any procedure involving the removal or injury of part or all of external female genitalia for non-medical reasons. While the practice is most common in Africa, Asia, and the Middle East, FGM is also widespread in immigrant communities and metropolitan areas in the United States, and was performed by doctors regularly until the 1980s.
There are four main types of FGM, distinguished by the World Health Organization by their severity. Type 1, clitoridectomy, describes the partial or total removal of the clitoris, and includes circumcision (removal of just the clitoral hood) and clitoridectomy (removal of the entire clitoral glans and hood). Type 2, excision, involves the partial or total removal of the clitoris and labia minora, with or without the additional removal of the labia majora. Type 3, infibulation, is the most severe type of FGM. It describes the narrowing of the vaginal opening through creation of a seal, by cutting and repositioning the labia minora or labia majora. Type 4 describes any other type of harmful non-medical procedures performed on female genitalia, including cutting, burning, and scraping.
In the United States, FGM is most common in immigrant communities and in major metropolitan areas. Data on the prevalence of FGM in the United States was first collected in 1990, using census information. CDC reports using information from the early 2010-2013 have shown a decrease in FGM in the United States, although growing levels of immigration cause numbers to appear higher.
In addition to its prevalence in immigrant communities in the US, FGM was considered a standard medical procedure in America for most of the 19th and 20th centuries. Physicians performed surgeries of varying invasiveness to treat a number of diagnoses, including hysteria, depression, nymphomania, and frigidity as well as to discourage masturbation. The medicalization of FGM in the United States allowed these practices to continue until the end of the 20th century, with some procedures covered by Blue Cross Blue Shield Insurance until 1977.
With the passage of the federal law ban, the Female Genital Mutilation Act, in 1996, performing FGM on anyone under age 18 became a felony in the United States. However, in 2018, the act was struck down as unconstitutional by US federal district judge Bernard A. Friedman in Michigan, who argued that the federal government did not have authority to enact legislation outside the "Interstate commerce" clause. As part of the ruling, Friedman also ordered that charges be dropped against 8 people who had mutilated the genitals of 9 girls. The Department of Justice decided not to appeal the ruling; however, the US House of Representatives appealed it. In 2021, the STOP FGM Act of 2020 was signed into law, and it gives federal authorities the power to prosecute those who carry out or conspire to carry out FGM, as well as increasing the maximum prison sentence from five to ten years. It also requires government agencies to report to Congress about the estimated number of females who are at risk of or have had FGM, and on efforts to prevent FGM.
As of August 2023, 41 U.S. states have made specific laws that prohibit FGM, while the remaining nine states have no specific laws against FGM. The US has also participated in several UN resolutions that advocate for the eradication of FGM, including the UN's 1948 Universal Declaration of Human Rights, 1989 Convention on the Rights of the Child, and the Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW).
Prevalence
The current prevalence of FGM in the US is uncertain. In early 2014, Equality Now campaigned with survivor and activist Jaha Dukureh, Representatives Joseph Crowley (D-NY) and Sheila Jackson Lee (D-TX), and The Guardian to petition the Obama Administration to conduct a new prevalence study into the current state of FGM in the U.S. as the first step towards its elimination.
In 1996, the first report on FGM in the United States was developed using data from the 1990 census. It reported that 168,000 girls and women were at risk, with 48,000 under 18. In 2004, the African Women's Health Center at Brigham and Women's Hospital and the PRC revamped these numbers with information from recent surveys and the 2000 U.S. census. They reported 227,887 girls and women at risk in United States, with 62,519 under 18. This increase can be attributed to increases in total immigration.